Provider Demographics
NPI:1710437744
Name:MATTHEWS, JAMES HOWARD (FNP)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:HOWARD
Last Name:MATTHEWS
Suffix:
Gender:M
Credentials:FNP
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 844568
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75284-4658
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:50 HILLCREST MEDICAL BLVD
Practice Address - Street 2:BLDG 1 STE. 201B
Practice Address - City:WACO
Practice Address - State:TX
Practice Address - Zip Code:76712-8952
Practice Address - Country:US
Practice Address - Phone:254-297-0515
Practice Address - Fax:254-297-0506
Is Sole Proprietor?:No
Enumeration Date:2016-10-13
Last Update Date:2022-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP130445363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily