Provider Demographics
NPI:1619370566
Name:MATTHEWS, AUSTIN E (MS, ATC, LAT)
Entity type:Individual
Prefix:MR
First Name:AUSTIN
Middle Name:E
Last Name:MATTHEWS
Suffix:
Gender:M
Credentials:MS, ATC, LAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11908 ANDERSON MILL RD
Mailing Address - Street 2:335
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78726-1100
Mailing Address - Country:US
Mailing Address - Phone:956-929-6179
Mailing Address - Fax:
Practice Address - Street 1:11908 ANDERSON MILL RD
Practice Address - Street 2:335
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78726-1100
Practice Address - Country:US
Practice Address - Phone:956-929-6179
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-10-07
Last Update Date:2014-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAT53212255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer