Individual
MATTHEW BOLES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
815 PENNSYLVANIA AVE, FORT WORTH, TX 76104-2294
(817) 321-0404
Mailing address
1320 S UNIVERSITY DR STE 500, FORT WORTH, TX 76107-5732
(817) 321-0404
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
0102204619
VA
2085R0202X
Diagnostic Radiology Physician
Primary
V5981
TX
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/25/2015
Last updated
02/18/2025
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