Individual
DR. JUSTIN MATTHEW DYNIEWSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1527 HEMPHILL ST, FORT WORTH, TX 76104-4706
(817) 569-5900
(817) 569-5998
Mailing address
1527 HEMPHILL ST, FORT WORTH, TX 76104-4706
(817) 569-5900
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
P2981
TX
2084P0804X
Child & Adolescent Psychiatry Physician
P2981
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
306484201
—
TX
01
—
306484202
MEDICAID CSHCN
TX
01
—
8DK337
BLUE CROSS BLUE SHIELD
TX
01
—
P01103934
RAILROAD MEDICARE
—
01
—
TXB160581
MEDICARE
TX
Enumeration date
05/25/2007
Last updated
01/30/2026
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