DR. TANNER L MATTISON (NPI# 1881657245) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1881657245 |
| Entity Type | Individual |
| Full Name | DR. TANNER L MATTISON |
| Credential | M.D. |
| Practice Address |
6221 Riverside Dr Suite 119 Irving TX 75039-3541 |
| Mailing Address |
410 N Utica Ave Lubbock TX 79416-3035 |
| Practice Telephone | 8772329924 |
| Practice Fax Number | 8062329927 |
| Mailing Telephone | 8067712018 |
| Mailing Fax Number | 8067712078 |
| Enumeration Date | 2006-04-07 |
| Last Update Date | 2013-07-31 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207ZP0102X |
Pathology Specialization: Anatomic Pathology & Clinical Pathology |
L2451 | TX | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AZ | 42717 | 05 | |
| CO | DR.0049728 | 05 | |
| NM | MD2008-0818 | 05 | |
| NC | 2008-02044 | 05 | |
| LA | MD.202224 | 05 | |
| NY | 49732-1 | 05 | |
| TX | L2451 | 05 |
| Street Address |
6221 RIVERSIDE DR SUITE 119 |
| City | IRVING |
| State | TX |
| Zip Code | 75039-3541 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124228077 | Jennifer Marie Hurrell | Pathology | 6221 Riverside Dr, Suite 119, Irving, TX 75039-3541 | 2007-07-19 |
| 1063619922 | Mattison Pathology, L.l.p. | Pathology | 6221 Riverside Dr, Suite 119, Irving, TX 75039-3541 | 2007-07-02 |
| 1255432563 | American Esoteric Laboratories | Clinical Medical Laboratory | 6221 Riverside Dr, Suite 119, Irving, TX 75039-3528 | 2006-09-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457976714 | Blue Light Therapies LLC | Clinic/Center | 421 E Royal Ln Suite 100, Irving, TN 75039 | 2020-06-12 |
| 1912537127 | Family Pharmacy @ Las Colinas LLC | Pharmacy | 6555 North State Hwy 161, Suite B, Irving, TX 75039 | 2020-01-16 |
| 1669011581 | Thrive House Therapy Pllc | Counselor | 5000 Riverside Drive, Bldg 6, Ste 100, Irving, TX 75039 | 2019-12-23 |
| 1265075048 | Juliana Dubey | Technician, Other | 400 E. Royal Ln, Building 3, Suite 290, Irving, TX 75039 | 2019-10-23 |
| 1932753894 | Jane Spagnoletti Niemtschk | Pharmacist | 750 West John Carpenter Freeway, Mc500, Irving, TX 75039 | 2019-07-30 |
| 1235796640 | Daniel Puig | Massage Therapist | 5000 Riverside Dr. Bldg 6 Ste. 100e, Irving, TX 75039 | 2019-05-21 |
| 1104301738 | Charity Maashe | Technician, Other | 400 E. Royal Lane, Bld 3, Ste 290, Irving, TX 75039 | 2018-09-28 |
| 1225545460 | Kuriachan Eye Institute, Pllc | Ophthalmology | 6750 N Macarthur Blvd Ste 331, Irving, TX 75039 | 2018-01-09 |
| 1619489978 | Eric Reaves | Assistant Behavior Analyst | 400 E. Royal Lane Bldg. 3, Suite 290, Irving, TX 75039 | 2017-10-26 |
| 1194247023 | Michael Do | Optometrist | 6445 Love Dr Apt 3035, Irving, TX 75039 | 2017-07-12 |
| Find all providers in zip 75039 | ||||
| Taxonomy Code | 207ZP0102X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pathology |
| Specialization | Anatomic Pathology & Clinical Pathology |
| A pathologist deals with the causes and nature of disease and contributes to diagnosis, prognosis and treatment through knowledge gained by the laboratory application of the biologic, chemical and physical sciences. A pathologist uses information gathered from the microscopic examination of tissue specimens, cells and body fluids, and from clinical laboratory tests on body fluids and secretions for the diagnosis, exclusion and monitoring of disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added, 7/1/2009: definition reformatted] Additional Resources: American Board of Pathology, 2007. http://www.abpath.org/ This taxonomy code identifies the combined anatomic pathology & clinical pathology route. Board certification for Medical Doctors (MDs) is provided by the American Board of Pathology. To acknowledge the diverse activities in the practice of pathology and to accommodate the interests of individuals wanting to enter the field, the ABP offers primary certification through the following three routes: combined anatomic pathology and clinical pathology, anatomic pathology only and clinical pathology only. Primary certification in anatomic pathology or clinical pathology may be combined with some of the subspecialty certifications. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184608028 | Carlos Manuel Torres | Pathology | 330 Las Colinas Blvd E, Suite 1316, Irving, TX 75039-5510 | 2005-12-05 |
| 1235112715 | Thuy-dung Thi Ardaman | Pathology | 8400 Esters Blvd, Suite 190, Irving, TX 75063-2203 | 2005-11-29 |
| 1467433292 | Inform Diagnostics, Inc | Pathology | 6655 North Macarthur Boulevard, Irving, TX 75039-2243 | 2005-11-09 |
| 1467433532 | Wei Michael Si | Pathology | 4770 Regent Blvd, Irving, TX 75063-2445 | 2005-11-07 |
| 1790789154 | Armineh Kajoian | Pathology | 6655 N Macarthur Blvd, Irving, TX 75039-2443 | 2005-06-13 |
| 1275895922 | Adeel Raza | Pathology | 4770 Regent Blvd, Irving, TX 75063-2445 | 2012-06-08 |
| 1134363260 | Lori Nicole Varghese | Pathology | 1901 N Macarthur Blvd, Irving, TX 75061-2220 | 2009-04-20 |
| 1184874125 | Kevin Orlando Turner | Pathology | 6655 N Macarthur Blvd, Irving, TX 75039 | 2008-09-26 |
| 1295991198 | Reenu Malhotra | Pathology | 6655 N Macarthur Blvd, Irving, TX 75039-2443 | 2008-07-31 |
| 1760647200 | Franto Francis | Pathology | 6655 N Macarthur Blvd, Irving, TX 75039-2443 | 2008-07-24 |
| Find all providers in IRVING | ||||
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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.