Provider Demographics
NPI:1730213869
Name:MATRIX ALLIANCE ASSOCIATES, P.A.
Entity type:Organization
Organization Name:MATRIX ALLIANCE ASSOCIATES, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:HAROLD
Authorized Official - Middle Name:C
Authorized Official - Last Name:URSCHEL
Authorized Official - Suffix:III
Authorized Official - Credentials:MD
Authorized Official - Phone:214-905-5090
Mailing Address - Street 1:8222 DOUGLAS AVE
Mailing Address - Street 2:SUITE 375
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75225-5923
Mailing Address - Country:US
Mailing Address - Phone:214-905-5090
Mailing Address - Fax:214-905-1998
Practice Address - Street 1:8222 DOUGLAS AVE
Practice Address - Street 2:SUITE 375
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75225-5923
Practice Address - Country:US
Practice Address - Phone:214-905-5090
Practice Address - Fax:214-905-1998
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-14
Last Update Date:2007-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health