Provider Demographics
NPI:1962020644
Name:HIRABAYASHI, MATTHEW THEODORE (MD)
Entity type:Individual
Prefix:
First Name:MATTHEW
Middle Name:THEODORE
Last Name:HIRABAYASHI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:9725 DATAPOINT DR STE 106
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78229-2385
Mailing Address - Country:US
Mailing Address - Phone:210-615-9358
Mailing Address - Fax:210-455-1596
Practice Address - Street 1:9725 DATAPOINT DR STE 106
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-2385
Practice Address - Country:US
Practice Address - Phone:210-615-9358
Practice Address - Fax:210-455-1596
Is Sole Proprietor?:No
Enumeration Date:2020-07-09
Last Update Date:2024-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2020014715207W00000X
TXU8999207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology