| Matthew M Davis Pllc | |
|
4231 Ridgecrest Cir Ste B Amarillo TX 79109-5498 | |
| (806) 803-5013 | |
| (806) 553-1312 |
| Full Name | Matthew M Davis Pllc |
|---|---|
| Speciality | Counselor |
| Location | 4231 Ridgecrest Cir Ste B, Amarillo, Texas |
| Authorized Official Name and Position | Matthew M Davis (THERAPIST) |
| Authorized Official Contact | 8068035013 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Matthew M Davis Pllc 4231 Ridgecrest Cir Ste B Amarillo TX 79109-5498 Ph: (806) 803-5013 | Matthew M Davis Pllc 4231 Ridgecrest Cir Ste B Amarillo TX 79109-5498 Ph: (806) 803-5013 |
| NPI Number | 1013639699 |
|---|---|
| Provider Enumeration Date | 09/12/2022 |
| Last Update Date | 01/02/2023 |
| Certification Date | 01/02/2023 |
| Medicare PECOS PAC ID | 6709236128 |
|---|---|
| Medicare Enrollment ID | O20231228000463 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013639699 | NPI | - | NPPES |
| 303185801 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
| Provider Name | Matthew M Davis |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1871841981 PECOS PAC ID: 7618327040 Enrollment ID: I20231228000584 |
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