Individual
DR. MATTHEW EIDEM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3242 PRESTON RD STE 200, PLANO, TX 75093-3311
(972) 867-0019
(972) 867-7785
Mailing address
7610 N STEMMONS FWY STE 600, DALLAS, TX 75247-4228
(214) 689-5960
(469) 713-8084
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
L3290
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
158659603
—
TX
01
—
8B4613
BCBSTX
TX
Enumeration date
08/24/2006
Last updated
09/25/2020
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