Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | M6017 | TX |
N | 111NI0900X | Internist | M6017 | TX |
Y | 207RC0200X | Critical Care Medicine | M6017 | TX |
N | 207RP1001X | Pulmonary Disease | M6017 | TX |
NPI | 1023221959 |
---|---|
Provider Name | Matthew Allen Anderson |
First Address | Austin, TX 78731-4530 |
Second Address | Austin, TX 78727-4107 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/05/2007 |
Last Update Date | 24/10/2016 |