Provider Demographics
NPI:1982610648
Name:MATTHEW B FURST MD PA
Entity type:Organization
Organization Name:MATTHEW B FURST MD PA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:BRIAN
Authorized Official - Last Name:FURST
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:432-580-8044
Mailing Address - Street 1:318 N ALLEGHANEY AVE
Mailing Address - Street 2:SUITE 400
Mailing Address - City:ODESSA
Mailing Address - State:TX
Mailing Address - Zip Code:79761-5052
Mailing Address - Country:US
Mailing Address - Phone:432-580-8044
Mailing Address - Fax:432-580-7820
Practice Address - Street 1:6005 EASTRIDGE RD STE 110
Practice Address - Street 2:
Practice Address - City:ODESSA
Practice Address - State:TX
Practice Address - Zip Code:79762-5021
Practice Address - Country:US
Practice Address - Phone:432-580-8044
Practice Address - Fax:432-253-3631
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-01
Last Update Date:2025-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0040PWOtherBCBS
TX126483002Medicaid
TX00N61KMedicare PIN
TX0040PWOtherBCBS