Individual
DR. THOMAS RANDOLPH MATTISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
410 N UTICA AVE, LUBBOCK, TX 79416-3035
(806) 776-1098
(806) 771-2078
Mailing address
410 N UTICA AVE, LUBBOCK, TX 79416-3035
(806) 776-1098
(806) 771-2078
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
E8700
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
262998-1
—
NY
05
—
44711
—
AZ
05
—
DR.0051861
—
CO
05
—
E8700
—
TX
05
—
MD2006-0026
—
NM
Enumeration date
08/30/2006
Last updated
04/19/2026
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