Provider Demographics
NPI:1689294340
Name:ROBERTS, MATTHEW HEARD
Entity Type:Individual
Prefix:MR
First Name:MATTHEW
Middle Name:HEARD
Last Name:ROBERTS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:DEPARTMENT OF NEUROLOGY RESIDENCY TRAINING PROGRAM
Mailing Address - Street 2:7703 FLOYD CURL DRIVE MSC 7883
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78229-3900
Mailing Address - Country:US
Mailing Address - Phone:210-450-0538
Mailing Address - Fax:
Practice Address - Street 1:DEPARTMENT OF NEUROLOGY RESIDENCY PROGRAM
Practice Address - Street 2:7703 FLOYD CURL DRIVE MSC 77883
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-3900
Practice Address - Country:US
Practice Address - Phone:210-450-0538
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-23
Last Update Date:2020-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program