Provider Demographics
NPI:1104874486
Name:MATTHEWS, MICHAEL PERRY (PHARM D)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:PERRY
Last Name:MATTHEWS
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 HURST CREEK RD
Mailing Address - Street 2:
Mailing Address - City:LAKEWAY
Mailing Address - State:TX
Mailing Address - Zip Code:78734-4223
Mailing Address - Country:US
Mailing Address - Phone:512-407-7800
Mailing Address - Fax:512-407-7805
Practice Address - Street 1:201 HURST CREEK RD
Practice Address - Street 2:
Practice Address - City:LAKEWAY
Practice Address - State:TX
Practice Address - Zip Code:78734-4223
Practice Address - Country:US
Practice Address - Phone:512-407-7800
Practice Address - Fax:512-407-7805
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX265901835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy