Organization
ANDREWS COUNTY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GORDON MATTIMOE DNP, APRN, FNP-C (AUTHORIZED OFFICIAL)
(432) 524-1434
Entity
Organization
Contact information
Practice address
208 NW 2ND ST, ANDREWS, TX 79714-6308
(432) 524-1434
(432) 524-1461
Mailing address
208 NW 2ND ST, ANDREWS, TX 79714-6308
(432) 524-1434
(432) 524-1461
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
017486401
—
TX
05
—
063303402
—
TX
05
—
094701201
—
TX
05
—
094701202
—
TX
05
—
094701203
—
TX
Enumeration date
09/27/2005
Last updated
10/29/2025
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