Individual
MATTHEW NELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
13915 NORTH MOPAC EXPRESSWAY, SUITE 200, AUSTIN, TX 78728
(512) 387-9213
Mailing address
1510 DEER PARK DR, VIDOR, TX 77662-2207
(936) 239-9410
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
211897
TX
Other
Enumeration date
11/13/2017
Last updated
11/13/2017
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