Provider Demographics
NPI:1558330530
Name:MOSBACKER, MATTHEW EDWARD (MD)
Entity Type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:EDWARD
Last Name:MOSBACKER
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:4511 HORIZON HILL BLVD
Mailing Address - Street 2:SUITE 150
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78229-2263
Mailing Address - Country:US
Mailing Address - Phone:210-477-2626
Mailing Address - Fax:210-477-2650
Practice Address - Street 1:4511 HORIZON HILL BLVD
Practice Address - Street 2:SUITE 150
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-2263
Practice Address - Country:US
Practice Address - Phone:210-477-2626
Practice Address - Fax:210-477-2650
Is Sole Proprietor?:No
Enumeration Date:2006-03-14
Last Update Date:2015-02-01
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXH9469207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8F5160Medicare PIN