MEDICARE: DR. MATTHEW WELDON CROSS MD

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	207Q00000X	Family Medicine Physician	P2844	TX
2	207P00000X	Emergency Medicine Physician	P2844	TX

General Provider Information

NPI Number	:	1982966099
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MATTHEW WELDON CROSS MD

Provider Business Mailing Address
First Line	:	PO BOX 6056
Second Line	:
City	:	CORPUS CHRISTI
State	:	TX
Zip	:	78466-6056
Country	:	US
Telephone Number	:	361-723-0226
Fax Number	:	512-852-4625

Provider Business Practice Location Address
First Line	:	410 E WILDWOOD DR
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78212-1758
Country	:	US
Telephone Number	:	210-542-1201
Fax Number	:

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

Provider Enumeration Date	:	06/13/2012
Last Update Date	:	08/30/2022

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