Individual
KIRK ANTHONY MATHEWS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
6901 MEDICAL PKWY, WACO, TX 76712-7910
(267) 978-3352
Mailing address
3101 BROSNAN RD, LORENA, TX 76655-3983
(267) 978-3352
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PA15481
TX
363AM0700X
Medical Physician Assistant
Primary
738222
TX
390200000X
Student in an Organized Health Care Education/Training Program
—
OK
Other
Enumeration date
09/23/2019
Last updated
12/13/2024
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