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Individual

DR. MATTHEW CHARLES FOX

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1601 TRINITY ST STOP 704, AUSTIN, TX 78712-1865
(512) 324-7468
Mailing address
1601 TRINITY ST STOP 704, AUSTIN, TX 78712-1865

Taxonomy

Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
4301091546
MI
207N00000X
Dermatology Physician
P2988
TX
207ND0101X
MOHS-Micrographic Surgery Physician
Primary
P2988
TX
207NS0135X
Procedural Dermatology Physician
4301091546
MI
207NS0135X
Procedural Dermatology Physician
P2988
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
310279001
TX
Enumeration date
08/05/2007
Last updated
11/25/2019
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