Provider Demographics
NPI:1033118021
Name:MATEY, DOUGLAS ANDREW JR (MD)
Entity Type:Individual
Prefix:
First Name:DOUGLAS
Middle Name:ANDREW
Last Name:MATEY
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 291411
Mailing Address - Street 2:
Mailing Address - City:KERRVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78029-1411
Mailing Address - Country:US
Mailing Address - Phone:830-792-6860
Mailing Address - Fax:830-792-3738
Practice Address - Street 1:1331 BANDERA HWY
Practice Address - Street 2:SUITE 3
Practice Address - City:KERRVILLE
Practice Address - State:TX
Practice Address - Zip Code:78028-9515
Practice Address - Country:US
Practice Address - Phone:830-792-6860
Practice Address - Fax:830-792-3738
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-07-20
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF7835207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXF7835OtherTEXAS MEDICAL LICENSE
TX40047644OtherTX DPS #
TX8M8100OtherBLUE CROSS - BLUE SHIELD
TX8M8100OtherBLUE CROSS - BLUE SHIELD
TX8M8100OtherBLUE CROSS - BLUE SHIELD
TX8B8613Medicare ID - Type Unspecified