Provider Demographics
NPI:1740605849
Name:WIGGINS, MATTHEW (PA-C)
Entity Type:Individual
Prefix:
First Name:MATTHEW
Middle Name:
Last Name:WIGGINS
Suffix:
Gender:M
Credentials:PA-C
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Mailing Address - Street 1:2967 OAK RUN PKWY STE 505
Mailing Address - Street 2:
Mailing Address - City:NEW BRAUNFELS
Mailing Address - State:TX
Mailing Address - Zip Code:78132-5379
Mailing Address - Country:US
Mailing Address - Phone:210-598-2800
Mailing Address - Fax:
Practice Address - Street 1:4708 ALLIANCE BLVD
Practice Address - Street 2:810
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-5340
Practice Address - Country:US
Practice Address - Phone:972-985-2797
Practice Address - Fax:972-985-4797
Is Sole Proprietor?:No
Enumeration Date:2014-02-26
Last Update Date:2022-03-15
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TX363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant