Provider Demographics
NPI:1528029030
Name:SCALAPINO, MATTHEW C (MD)
Entity Type:Individual
Prefix:
First Name:MATTHEW
Middle Name:C
Last Name:SCALAPINO
Suffix:
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 3780
Mailing Address - Street 2:
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79116-3780
Mailing Address - Country:US
Mailing Address - Phone:806-355-3352
Mailing Address - Fax:
Practice Address - Street 1:1901 MEDI PARK
Practice Address - Street 2:STE 2050
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79106-2110
Practice Address - Country:US
Practice Address - Phone:806-355-3352
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-04-01
Last Update Date:2008-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH14092085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXMDH1409OtherWORKERS COMPENSATION
OK100138770AMedicaid
TX82R445OtherBLUE CROSS
TX131507901Medicaid
123334100OtherFIRSTCARE
NMX4955Medicaid
TX82R445OtherBLUE CROSS
123334100OtherFIRSTCARE
TXMDH1409OtherWORKERS COMPENSATION
NMX4955Medicaid