Organization
MATLOCK EMERGENCY PHYSICIANS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WILLIAM C JERNBERG MD (PRESIDENT-GENERAL PARTNER)
(214) 712-2489
Entity
Organization
Contact information
Practice address
801 INTERSTATE 20 W, ARLINGTON, TX 76017-5851
(817) 472-3400
(214) 712-2487
Mailing address
1717 MAIN ST, SUITE 5200, DALLAS, TX 75201-4612
(214) 712-2489
(214) 712-2487
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
—
—
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0057KP
BCBS
TX
Enumeration date
11/28/2006
Last updated
04/20/2008
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