Individual
DR. MATTHEW PAUL CLEMONS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3500 GASTON AVE, DALLAS, TX 75246-2017
(214) 820-2361
Mailing address
3500 GASTON AVE, DALLAS, TX 75246-2017
(214) 820-0111
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
R8546
TX
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
424673801
—
TX
Enumeration date
05/16/2017
Last updated
07/21/2022
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