Individual
MATTHEW GENE MAA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MSN, PMHNP-BC
Contact information
Practice address
1221 W BEN WHITE BLVD, SUITE B300, AUSTIN, TX 78704-7192
(512) 524-9293
Mailing address
205 E UNIVERSITY AVE STE 200, GEORGETOWN, TX 78626-6821
(877) 800-5722
(512) 869-2940
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
AP124012
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3317794-01
—
TX
Enumeration date
09/06/2013
Last updated
03/07/2018
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