Provider Demographics
NPI:1619511300
Name:SOUTH GARLAND MEDICAL PLLC
Entity Type:Organization
Organization Name:SOUTH GARLAND MEDICAL PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PROVIDER
Authorized Official - Prefix:DR
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:S
Authorized Official - Last Name:CARTER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:972-535-6800
Mailing Address - Street 1:1301 NORTHWEST HWY STE 209
Mailing Address - Street 2:
Mailing Address - City:GARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:75041-5896
Mailing Address - Country:US
Mailing Address - Phone:972-535-6800
Mailing Address - Fax:
Practice Address - Street 1:1301 NORTHWEST HWY STE 209
Practice Address - Street 2:
Practice Address - City:GARLAND
Practice Address - State:TX
Practice Address - Zip Code:75041-5896
Practice Address - Country:US
Practice Address - Phone:972-535-6800
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-11-05
Last Update Date:2019-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Multi-Specialty
No2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain MedicineGroup - Multi-Specialty