DR. MANDEEP S MATTA (NPI# 1295053072) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1295053072 |
| Entity Type | Individual |
| Full Name | DR. MANDEEP S MATTA |
| Credential | M.D. |
| Practice Address |
1350 S Main St Fort Worth TX 76104-7611 |
| Mailing Address |
1617 Hemphill St Fort Worth TX 76104-4709 |
| Practice Telephone | 8179273701 |
| Practice Fax Number | 8179206924 |
| Mailing Telephone | 8179273701 |
| Mailing Fax Number | 8179206924 |
| Enumeration Date | 2010-05-04 |
| Last Update Date | 2015-06-16 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207R00000X | Internal Medicine | 256906 | NY | Allopathic & Osteopathic Physicians |
| Y | 207RI0200X |
Internal Medicine Specialization: Infectious Disease |
256906 | NY | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | 03401810 | 05 |
| Street Address |
1350 S MAIN ST |
| City | FORT WORTH |
| State | TX |
| Zip Code | 76104-7611 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831638980 | Daphne Rene Jones | Nurse Practitioner | 1350 S Main St, Ste 1250, Fort Worth, TX 76104-7611 | 2017-02-21 |
| 1679027759 | Esther Fasanmi | Pharmacist | 1350 S Main St, Suite 1600, Fort Worth, TX 76104-7611 | 2016-08-07 |
| 1609257534 | Petya Taskov | Nurse Practitioner | 1350 S Main St, Suite 306, Fort Worth, TX 76104-7611 | 2015-06-16 |
| 1144428558 | Esmeralda Lorna Howard | Nurse Practitioner | 1350 S Main St, Suite # 3200, Fort Worth, TX 76104-7611 | 2007-07-06 |
| 1699893040 | Phillip H Skinner Md Pa | Ophthalmology | 1350 S Main St, Ste 110, Fort Worth, TX 76104 | 2007-03-26 |
| 1992838726 | Phillip Howard Skinner | Ophthalmology | 1350 S Main St, #1100, Fort Worth, TX 76104 | 2007-03-13 |
| 1730228727 | Robin Mckelvey | Internal Medicine | 1350 S Main St, Suite 1600, Fort Worth, TX 76104-7611 | 2007-02-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669082186 | Cvs Pharmacy, Inc. | Durable Medical Equipment & Medical Supplies | 1115 8th St, Fort Worth, TX 76104 | 2020-08-10 |
| 1992343693 | Iris Giove | Psychologist | John Peter Smith Hospital, 1500 S. Main St., Fort Worth, TX 76104 | 2019-12-13 |
| 1104480656 | Swarnalaxmi Umapathy | Student in an Organized Health Care Education/Training Program | 900 8th Avenue, Fort Worth, TX 76104 | 2019-04-30 |
| 1881189132 | Mega Surgical Assistants LLC | Specialist/Technologist, Other | 1301pennsylvania, Fort Worth, TX 76104 | 2018-06-28 |
| 1356848899 | Tricia Kelly | Nurse Practitioner | 1325 Pennsylvania Avenue Suite 560, Fort Worth, TX 76104 | 2018-04-11 |
| 1952820979 | Modern Vein Clinic | Internal Medicine | 757 8th Avenue, Suite A, Forth Worth, TX 76104 | 2017-09-11 |
| 1790207165 | Vanessa Abbood | Dietitian, Registered | 900 Eighth Ave, Fns Department, Fort Worth, TX 76104 | 2017-07-07 |
| 1922537562 | Nicole Marie Tod | Student in an Organized Health Care Education/Training Program | 1500 S Main Street, Fort Worth, TX 76104 | 2017-06-07 |
| 1770025934 | Micah Bonola | Chiropractor | 1300 W. Rosedale St, Ste. A, Fort Worth, TX 76104 | 2016-11-04 |
| 1518315894 | United Bioscience, LLC. | Clinical Medical Laboratory | 901 W. Leuda St., B, Fort Worth, TX 76104 | 2016-05-27 |
| Find all providers in zip 76104 | ||||
| Taxonomy Code | 207RI0200X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Infectious Disease |
| An internist who deals with infectious diseases of all types and in all organ systems. Conditions requiring selective use of antibiotics call for this special skill. This physician often diagnoses and treats AIDS patients and patients with fevers which have not been explained. Infectious disease specialists may also have expertise in preventive medicine and travel medicine. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447488028 | Miloni Shroff | Internal Medicine | 1325 Pennsylvania Ave Ste 325, Fort Worth, TX 76104-2175 | 2009-06-23 |
| 1497858435 | Kavitha Shashikumar | Internal Medicine | 11803 South Freeway, Suite 104, Fort Worth, TX 76115-0000 | 2006-09-06 |
| 1669447157 | Daniel Barbaro | Internal Medicine | 1025 College Ave, Fort Worth, TX 76104-3013 | 2006-02-20 |
| 1265407761 | Mark J Hupert | Internal Medicine | 1124 College Ave, Fort Worth, TX 76104-4557 | 2006-02-20 |
| 1013982511 | Cheryl K Mcdonald | Internal Medicine | 1125 College Ave, Fort Worth, TX 76104-4514 | 2006-02-20 |
| 1275533846 | Catherine A Colquitt | Internal Medicine | 1307 8th Avenue, Suite 502, Fort Worth, TX 76104-4141 | 2005-07-26 |
| 1598769333 | Allan Rowan Kelly | Internal Medicine | 929 College Ave, Fort Worth, TX 76104-3048 | 2005-06-09 |
| 1205487717 | Infectious Diseases Consultants of Texas Pllc | Internal Medicine | 6551 Harris Pkwy Ste 110, Fort Worth, TX 76132-6105 | 2019-09-25 |
| 1982013439 | Deepthi Bibinagar | Internal Medicine | 400 N Beach St Ste 104, Fort Worth, TX 76111-7070 | 2014-08-08 |
| 1336569433 | Gennifer Meilyse Garmon | Internal Medicine | 1325 Pennsylvania Ave Ste 325, Fort Worth, TX 76104-2175 | 2014-04-16 |
| Find all providers in FORT WORTH | ||||
| City | FORT WORTH |
| Zip Code | 76104 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.