Individual
CHARLES HARRISON MATTHEWS JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2600 SAINT MICHAEL DR, TEXARKANA, TX 75503-2372
(903) 614-2666
Mailing address
2800 E HWY 114, SUITE 100, TROPHY CLUB, TX 76262-5305
(817) 693-0900
(713) 863-8308
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
001964
GA
2085R0001X
Radiation Oncology Physician
01078263A
IN
2085R0001X
Radiation Oncology Physician
Primary
Q2340
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1I0164
MEDICARE
TX
05
—
348741503
—
TX
01
—
P02587361
RR MEDICARE
TX
Enumeration date
04/16/2007
Last updated
11/20/2023
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