Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | MT200526 | PA |
N | 111NI0900X | Internist | MT200526 | PA |
Y | 207RH0003X | Hematology & Oncology | R8326 | TX |
NPI | 1013297167 |
---|---|
Provider Name | Dr. Matthew James Butler |
First Address | San Antonio, TX 78229-3901 |
Second Address | San Antonio, TX 78229-4427 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/08/2011 |
Last Update Date | 21/09/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
386989301 | (05) | TX |
386989302 | CSHCN (01) | TX |