Provider Demographics
NPI:1881859056
Name:PHARES, MATTHEW ABRAHAM (DO)
Entity Type:Individual
Prefix:
First Name:MATTHEW
Middle Name:ABRAHAM
Last Name:PHARES
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:176 DEER CREEK DR
Mailing Address - Street 2:
Mailing Address - City:ALEDO
Mailing Address - State:TX
Mailing Address - Zip Code:76008-3900
Mailing Address - Country:US
Mailing Address - Phone:956-443-3000
Mailing Address - Fax:956-443-3000
Practice Address - Street 1:176 DEER CREEK DR
Practice Address - Street 2:
Practice Address - City:ALEDO
Practice Address - State:TX
Practice Address - Zip Code:76008-3900
Practice Address - Country:US
Practice Address - Phone:956-443-3000
Practice Address - Fax:956-443-3000
Is Sole Proprietor?:No
Enumeration Date:2008-07-27
Last Update Date:2015-01-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXP1386207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine