Provider Demographics
NPI:1316103757
Name:DFW HOSPITALISTS
Entity type:Organization
Organization Name:DFW HOSPITALISTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JONATHAN
Authorized Official - Middle Name:R
Authorized Official - Last Name:MATTHEWS
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:817-490-9841
Mailing Address - Street 1:12 KATIE LN
Mailing Address - Street 2:
Mailing Address - City:TROPHY CLUB
Mailing Address - State:TX
Mailing Address - Zip Code:76262-5549
Mailing Address - Country:US
Mailing Address - Phone:817-490-9841
Mailing Address - Fax:817-490-9838
Practice Address - Street 1:12 KATIE LN
Practice Address - Street 2:
Practice Address - City:TROPHY CLUB
Practice Address - State:TX
Practice Address - Zip Code:76262-5549
Practice Address - Country:US
Practice Address - Phone:817-490-9841
Practice Address - Fax:817-490-9838
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-05
Last Update Date:2009-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXDO6001OtherRAILROAD MEDICARE
TX202307901Medicaid
TX00Z965Medicare PIN
TX00Z969Medicare PIN
I74387Medicare UPIN