Individual
DR. MATTHEW T VANDER WOUDE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
3111 MCCANN RD, LONGVIEW, TX 75605-7842
(903) 753-1212
Mailing address
3111 MCCANN RD, LONGVIEW, TX 75605-7842
(903) 753-1212
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
934
NV
207P00000X
Emergency Medicine Physician
Primary
S1942
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201875024
—
NV
Enumeration date
05/23/2005
Last updated
10/19/2022
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