Provider Demographics
NPI:1992797799
Name:HAND, MATTHEW M (PAC)
Entity type:Individual
Prefix:
First Name:MATTHEW
Middle Name:M
Last Name:HAND
Suffix:
Gender:M
Credentials:PAC
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:3200 QUAIL SPRINGS PKWY
Mailing Address - Street 2:SUITE 200
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73134-2604
Mailing Address - Country:US
Mailing Address - Phone:405-701-9880
Mailing Address - Fax:405-701-9881
Practice Address - Street 1:619 S FLEISHEL AVE
Practice Address - Street 2:SUITE 101
Practice Address - City:TYLER
Practice Address - State:TX
Practice Address - Zip Code:75701-2004
Practice Address - Country:US
Practice Address - Phone:903-595-5514
Practice Address - Fax:903-262-3702
Is Sole Proprietor?:No
Enumeration Date:2005-08-17
Last Update Date:2016-10-04
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
OK2557363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX82N320Medicare ID - Type Unspecified
S70931Medicare UPIN