MEDICARE: DR. MATTHEW A HAMMONS M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207W00000X	Ophthalmology Physician	M1741	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1639189319
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MATTHEW A HAMMONS M.D.

Provider Business Mailing Address
First Line	:	P.O. BOX 961205
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76161-1205
Country	:	US
Telephone Number	:	817-740-8450
Fax Number	:

Provider Business Practice Location Address
First Line	:	800 8TH AVE
Second Line	:	STE 330
City	:	FORT WORTH
State	:	TX
Zip	:	76104-2601
Country	:	US
Telephone Number	:	817-566-1500
Fax Number	:	682-432-0763

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/08/2006
Last Update Date	:	09/20/2019

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