DR. MARK WALKER MATTHEWS (NPI# 1609090471) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1609090471 |
| Entity Type | Individual |
| Full Name | DR. MARK WALKER MATTHEWS |
| Credential | PHD |
| Practice Address |
305 Miron Dr Suite 400-a Southlake TX 76092-7831 |
| Mailing Address |
8017 Crazy Horse Ln Fort Worth TX 76137-4161 |
| Practice Telephone | 8179093766 |
| Practice Fax Number | 8174799496 |
| Mailing Telephone | 8175775717 |
| Enumeration Date | 2007-04-12 |
| Last Update Date | 2015-03-17 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
31431 | TX | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | 1031619 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790218196 | Mark Matthews | Counselor | 1233 E Mount Pleasant Rd Apt 504, Zachary, LA 70791 | 2017-04-04 |
| 1013101914 | Mark A. Matthews | Licensed Practical Nurse | 6310 7th Ave, 6313 7th Avenue, Los Angeles, CA 90043-4275 | 2007-09-04 |
| 1457716797 | Mark Matthews | Counselor | 340 Nw 5th St, Box 1710, Redmond, OR 97756-1869 | 2015-12-30 |
| 1467589499 | Mark K Matthews | Internal Medicine | 1375 E 20th Ave, Denver, CO 80205-5423 | 2007-02-27 |
| 1710085634 | Mark Alan Matthews | Counselor | 1515 N Stephenson Hwy, Royal Oak, MI 48067-1526 | 2006-09-21 |
| 1245348390 | Mark A Matthews | Internal Medicine | 1110 W Peachtree St Nw Ste 920, Atlanta, GA 30309-3609 | 2006-08-28 |
| 1780799312 | Mark James Matthews | Dentist | 214 Larkin St, Tomah, WI 54660-0606 | 2006-08-21 |
| 1245264647 | Mark Matthews | Radiology | 218 S Herlong Ave, Rock Hill, SC 29732-1158 | 2006-07-10 |
| 1760436455 | Mark Thomas Matthews | Family Medicine | 26501 Avenue 140, Porterville, CA 93258-2000 | 2006-05-19 |
| 1083694418 | Mark R Matthews | Pathology | 6655 N Macarthur Blvd, Irving, TX 75039-2443 | 2006-01-20 |
| Street Address |
305 MIRON DR SUITE 400-A |
| City | SOUTHLAKE |
| State | TX |
| Zip Code | 76092-7831 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114966074 | H. E. B. Behavioral Medicine, P. C. | Psychologist | 305 Miron Dr, Southlake, TX 76092-7831 | 2006-06-06 |
| 1578982401 | Krista Kulesza, Ph.d., LLC | Psychologist | 305 Miron Dr, Southlake, TX 76092-7831 | 2014-04-08 |
| 1023444932 | Dabal Marital Counseling | Marriage & Family Therapist | 305 Miron Dr, Southlake, TX 76092-7831 | 2013-09-24 |
| 1013232032 | Maryellen Dabal | Marriage & Family Therapist | 305 Miron Dr, Southlake, TX 76092-7831 | 2010-04-01 |
| 1437319225 | Rebecca B. Lapidus, Phd, PC | Community/Behavioral Health | 305 Miron Dr, Southlake, TX 76092-7831 | 2008-06-15 |
| 1477727741 | Lori Ann Shahidi | Psychiatry & Neurology | 305 Miron Dr, Southlake, TX 76092-7831 | 2008-04-17 |
| 1558304691 | Dana Beth Turnbull | Psychologist | 305 Miron Dr, Southlake, TX 76092-7831 | 2006-06-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730718990 | Elizabeth Beazley | Family Medicine | 1050 E. Hwy 114 Suite 100, Southlake, TX 76092 | 2020-04-08 |
| 1518508894 | Arbor Pediatrics, Pllc | Pediatrics | 1130 N Kimball Ave, Southlake, TX 76092 | 2019-10-08 |
| 1346882685 | Gs Ortho Assists, Pllc | Physician Assistant | 2600 East Southlake Boulevard Suite 120, Southlake, TX 76092 | 2019-10-08 |
| 1609340496 | Rebecca Leigh Lander | Physician Assistant | 1170 N Carroll Ave., Southlake, TX 76092 | 2019-01-15 |
| 1225506223 | Physicians Wellness Associates Pllc | Family Medicine | 1920 East State Highway 114, Southlake, TX 76092 | 2018-11-07 |
| 1740762459 | Brandi L. Barker | Chiropractor | 590 N. Kimball Ave, Suite 140, Southlake, TX 76092 | 2018-08-30 |
| 1033699228 | Julie A. Seeber | Physical Therapy Assistant | 170 Stonebridge Lane, Southlake, TX 76092 | 2018-08-16 |
| 1992281364 | Alayna Powers | Nurse Practitioner | 900 E Southlake Blvd Ste 300, Southlake, TX 76092 | 2018-07-18 |
| 1346732153 | Amrittej Singh Virk | Dentist | 630 N Kimball Ave Ste 110, Southlake, TX 76092 | 2018-06-06 |
| 1740779594 | Radiant Family Dental Pllc | Dentist | 2012 Southlake Glen Dr., Southlake, TX 76092 | 2018-05-08 |
| Find all providers in zip 76092 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518409374 | Linda Hoover | Psychologist | 185 S. Kimball Ave, Suite 100, Southlake, TX 76092 | 2016-11-10 |
| 1467892810 | Ar Psychological Services Pllc | Psychologist | 231 E Southlake Blvd, Suite 140, Southlake, TX 76092-6285 | 2013-06-30 |
| 1023313939 | Ashley Harrison Noble | Psychologist | 211 E Southlake Blvd Ste 101, Southlake, TX 76092-6274 | 2011-01-24 |
| 1467696823 | Amanpreet Randazzo | Psychologist | 1009 Berkshire Rd, Southlake, TX 76092-4911 | 2009-04-28 |
| 1699950782 | Marietta Baccus Richard | Psychologist | 1725 E Southlake Blvd Ste 102, Southlake, TX 76092-6457 | 2008-01-08 |
| 1689754541 | Robert E Holmes | Psychologist | 2485 E Southlake Blvd Ste 180, Southlake, TX 76092-6687 | 2006-10-16 |
| 1235229766 | April Minatrea | Psychologist | 211 E Southlake Blvd, Suite 115, Southlake, TX 76092-6265 | 2006-10-13 |
| 1336156975 | Mark S Rider | Psychologist | 558 Silicon Dr, #102, Southlake, TX 76092-7529 | 2006-08-02 |
| 1114966074 | H. E. B. Behavioral Medicine, P. C. | Psychologist | 305 Miron Dr, Southlake, TX 76092-7831 | 2006-06-06 |
| 1174956700 | Robert N Freedenfeld, Phd, PC | Psychologist | 1207 S White Chapel Blvd, Suite 140, Southlake, TX 76092-9314 | 2013-08-19 |
| Find all providers in SOUTHLAKE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.