Provider Demographics
NPI:1528157617
Name:TROVATO, MATTHEW J (MD)
Entity type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:J
Last Name:TROVATO
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:16633 DALLAS PKWY
Mailing Address - Street 2:SUITE 350
Mailing Address - City:ADDISON
Mailing Address - State:TX
Mailing Address - Zip Code:75001-6816
Mailing Address - Country:US
Mailing Address - Phone:214-542-0973
Mailing Address - Fax:214-206-9098
Practice Address - Street 1:16633 DALLAS PKWY
Practice Address - Street 2:SUITE 350
Practice Address - City:ADDISON
Practice Address - State:TX
Practice Address - Zip Code:75001-6816
Practice Address - Country:US
Practice Address - Phone:214-542-0973
Practice Address - Fax:214-206-9098
Is Sole Proprietor?:No
Enumeration Date:2006-10-12
Last Update Date:2016-07-11
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MA08130400208200000X
CAA973142086S0122X
TXN6725208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
No2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive Surgery