Provider Demographics
NPI:1508200288
Name:HYZY, MATTHEW W (DO)
Entity Type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:W
Last Name:HYZY
Suffix:
Gender:M
Credentials:DO
Other - Prefix:DR
Other - First Name:MATTHEW
Other - Middle Name:W
Other - Last Name:HYZY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DO
Mailing Address - Street 1:1776 WOODSTEAD CT STE 208
Mailing Address - Street 2:
Mailing Address - City:THE WOODLANDS
Mailing Address - State:TX
Mailing Address - Zip Code:77380-1480
Mailing Address - Country:US
Mailing Address - Phone:877-749-7428
Mailing Address - Fax:512-628-3314
Practice Address - Street 1:403 SUMMIT BLVD UNIT 201
Practice Address - Street 2:
Practice Address - City:BROOMFIELD
Practice Address - State:CO
Practice Address - Zip Code:80021-8253
Practice Address - Country:US
Practice Address - Phone:303-429-6448
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-04-24
Last Update Date:2020-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0056574208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation