Individual
DR. KELLY DAWN MATTIX
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1901 SW H K DODGEN LOOP, TEMPLE, TX 76502-1814
(254) 724-5437
Mailing address
PO BOX 844568, DALLAS, TX 75284-4658
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
E-17038
AR
2086S0120X
Pediatric Surgery Physician
Primary
E-17038
AR
2086S0120X
Pediatric Surgery Physician
N7560
TX
Other
Enumeration date
04/11/2008
Last updated
10/03/2023
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