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Individual

DR. MATTHEW DRISCOLL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1301 W 38TH ST STE 102, AUSTIN, TX 78705-1010
(512) 454-4561
(512) 406-7330
Mailing address
4515 SETON CENTER PKWY, SUITE 215-CREDENTIALING, AUSTIN, TX 78759-5290
(512) 231-5548
(512) 406-6216

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
P8581
TX
390200000X
Student in an Organized Health Care Education/Training Program
BP10031393
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
338738301
TX
05
338738302
TX
Enumeration date
09/03/2008
Last updated
03/12/2015
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