Provider Demographics
NPI:1346615382
Name:MYERS, MATTHEW
Entity type:Individual
Prefix:
First Name:MATTHEW
Middle Name:
Last Name:MYERS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1343 BANDERA HWY
Mailing Address - Street 2:#102
Mailing Address - City:KERRVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78028-9741
Mailing Address - Country:US
Mailing Address - Phone:830-446-1492
Mailing Address - Fax:
Practice Address - Street 1:1343 BANDERA HWY
Practice Address - Street 2:#102
Practice Address - City:KERRVILLE
Practice Address - State:TX
Practice Address - Zip Code:78028-9741
Practice Address - Country:US
Practice Address - Phone:830-446-1492
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-12-02
Last Update Date:2015-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)