Provider Demographics
NPI:1831577436
Name:MATTHEWS, ANTOINETTE (MD)
Entity type:Individual
Prefix:DR
First Name:ANTOINETTE
Middle Name:
Last Name:MATTHEWS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:ANTOINETTE
Other - Middle Name:
Other - Last Name:DAY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 911230
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75391-1230
Mailing Address - Country:US
Mailing Address - Phone:972-997-8000
Mailing Address - Fax:972-234-2987
Practice Address - Street 1:3410 WORTH STREET, SUITE 400
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75246
Practice Address - Country:US
Practice Address - Phone:214-370-1000
Practice Address - Fax:214-370-1986
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-14
Last Update Date:2022-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXR1415207R00000X, 207RH0003X
TXTBD207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX426382401Medicaid