Provider Demographics
NPI:1659362218
Name:RETZLOFF, MATTHEW GERARD (MD)
Entity type:Individual
Prefix:
First Name:MATTHEW
Middle Name:GERARD
Last Name:RETZLOFF
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7707 EWING HALSELL , SUITE 103
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78229-4040
Mailing Address - Country:US
Mailing Address - Phone:210-692-0577
Mailing Address - Fax:210-692-1210
Practice Address - Street 1:7707 EWING HALSELL, SUITE 103
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-4040
Practice Address - Country:US
Practice Address - Phone:210-692-0577
Practice Address - Fax:210-692-1210
Is Sole Proprietor?:No
Enumeration Date:2005-11-02
Last Update Date:2024-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ8736207V00000X, 207VE0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VE0102XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyReproductive Endocrinology
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology