MEDICARE: DR. TANNER LAYNE MATTISON 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	207ZP0102X	Anatomic Pathology & Clinical Pathology Physician	L2451	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
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
7	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1881657245
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. TANNER LAYNE MATTISON M.D.

Provider Business Mailing Address
First Line	:	2609 SIR GAWAIN LN
Second Line	:
City	:	LEWISVILLE
State	:	TX
Zip	:	75056-5719
Country	:	US
Telephone Number	:	214-392-5871
Fax Number	:

Provider Business Practice Location Address
First Line	:	2609 SIR GAWAIN LN
Second Line	:
City	:	LEWISVILLE
State	:	TX
Zip	:	75056-5719
Country	:	US
Telephone Number	:	214-392-5871
Fax Number	:

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

Provider Enumeration Date	:	04/07/2006
Last Update Date	:	04/03/2024

Similar Medicare Providers

1306543525 — ERIN PODGORSKI PA-C
Practice Location Address:

1700 FM 544 STE 100
LEWISVILLE, TX
75056-4915

Practice Phone: 972-394-4600
Practice Fax:

1336002641 — TAYLAR ALLEN
Practice Location Address:

4400 STATE HIGHWAY 121 STE 300
LEWISVILLE, TX
75056-5157

Practice Phone: 833-932-3137
Practice Fax:

1235136060 — ORTHOFIX US LLC
Practice Location Address:

3451 PLANO PKWY
LEWISVILLE, TX
75056-9453

Practice Phone: 214-937-2000
Practice Fax: 877-246-4605

1336149079 — DR. FRANZ JULIUS LUCAS D.D.S.
Practice Location Address:

2540 KING ARTHUR BLVD , SUITE 160
LEWISVILLE, TX
75056-5579

Practice Phone: 972-899-9288
Practice Fax: 972-899-9290

1801898671 — TRAVIS MICHAEL STERLING PT, OCS, CSCS
Practice Location Address:

4770 STATE HIGHWAY 121 STE 130
LEWISVILLE, TX
75056-2913

Practice Phone: 469-830-9030
Practice Fax:

1124014303 — DR. ALBERT THIBEAUX MD
Practice Location Address:

2602 SIR GAWAIN LN
LEWISVILLE, TX
75056-5718

Practice Phone: 972-899-2477
Practice Fax: 972-899-2477

Directions to “ DR. TANNER LAYNE MATTISON M.D.” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.