Basic Information
| Provider Information | |||||||||
| NPI: | 1073817235 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | MATTHEW J WINDROW MD PA | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 858 | ||||||||
| Address2: | |||||||||
| City: | HONDO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 788610858 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5122807943 | ||||||||
| FaxNumber: | 5122915657 | ||||||||
| Practice Location | |||||||||
| Address1: | 3200 AVENUE E | ||||||||
| Address2: | |||||||||
| City: | HONDO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 788613525 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5122807943 | ||||||||
| FaxNumber: | 5122915657 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/03/2011 | ||||||||
| LastUpdateDate: | 01/03/2011 | ||||||||
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| AuthorizedOfficialLastName: | DEVOS | ||||||||
| AuthorizedOfficialFirstName: | CAROLE | ||||||||
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| AuthorizedOfficialTitleorPosition: | CONTRACTING SUPERVISOR | ||||||||
| AuthorizedOfficialTelephone: | 5126924010 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MRS. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | K3041 | TX | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.