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Organization
JARED MATASKA MD PA
Active
Organization
JARED MATASKA MD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JARED MATASKA MD (MANAGING OWNER)
(940) 521-5500
Entity
Organization
Contact information
Practice address
1339 EAST ST, GRAHAM, TX 76450-4228
(940) 521-5500
Mailing address
1339 EAST ST, GRAHAM, TX 76450-4228
(940) 521-5500
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
R4429
TMB LICENSE
TX
Enumeration date
01/25/2019
Last updated
03/03/2021
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