Mattison, Tanner Layne

Mattison, Tanner Layne is an individual health care provider with primary practice located at 2609 Sir Gawain Ln , Lewisville TX 75056-5719. He recently has only one registered license in Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology, which is considered as his primary health care specialty. Mattison, Tanner Layne can be contacted via phone (214) 392-5871.

Contact Information

Primary practice address
2609 Sir Gawain Ln Lewisville TX 75056-5719
Phone: (214) 392-5871
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology 207ZP0102X L2451 Texas

Profile Details

NPI number 1881657245
LBN Legal business name Mattison, Tanner Layne
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 7th, 2006
Last updated Apr 3rd, 2024 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1881657245 NPPES
Colorado MEDICAID DR.0049728
Colorado MEDICAID MD.202224
Colorado MEDICAID 2008-02044
Colorado MEDICAID 42717
Colorado MEDICAID L2451
Colorado MEDICAID MD2008-0818
Colorado MEDICAID 49732-1

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