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Individual
DR. MATTHEW TODD PROCTOR
Active
Individual
DR. MATTHEW TODD PROCTOR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
L3209
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
152404312
—
TX
05
—
160029801
—
TX
05
—
160029802
—
TX
01
—
75-2616977-002
TRICARE
TX
01
—
75-2616977-113
TRICARE
TX
01
—
752616977113
TRICARE
TX
01
—
8DZ886
BCBS BLUE
TX
01
—
P00688868
RAIL ROAD
TX
01
—
P01304431
RAIL ROAD
TX
Enumeration date
06/30/2006
Last updated
02/13/2024
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