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NPI Code Detail

MEDICARE: MATTHEW M HAND PAC

MEDICARE: MATTHEW M HAND PAC
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
1363A00000XPhysician Assistant2557OK

General Provider Information

NPI Number : 1992797799
Entity Type Code : Individual
Provider Name (Legal Business Name) : MATTHEW M HAND PAC
Provider Business Mailing Address
First Line : 3200 QUAIL SPRINGS PKWY
Second Line : SUITE 200
City : OKLAHOMA CITY
State : OK
Zip : 73134-2604
Country : US
Telephone Number : 405-701-9880
Fax Number : 405-701-9881
Provider Business Practice Location Address
First Line : 619 S FLEISHEL AVE
Second Line : SUITE 101
City : TYLER
State : TX
Zip : 75701-2004
Country : US
Telephone Number : 903-595-5514
Fax Number : 903-262-3702
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/17/2005
Last Update Date : 10/04/2016

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