Matrix Medical Assistants, PLLC

Primary specialty

Point of ServiceTaxonomy code 305S00000X

Legal business name

MATRIX MEDICAL ASSISTANTS, PLLC

Practice address

4518 Irvin Simmons Dr
Dallas, TX 75229-4249

Phone

(817) 969-6030

NPI assigned

Oct 7, 2020

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mark Lundgren

Title

Practice Administrator

Phone

(817) 969-6030

Specialties & licenses 1

Addresses

Other names 1

• Matrix Medical Assistants, PLLC Other name

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1602028800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1602028800000",
    "number": "1669079174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4518 IRVIN SIMMONS DR",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752294249",
            "telephone_number": "817-969-6030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4518 IRVIN SIMMONS DR",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752294249",
            "telephone_number": "817-969-6030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MATRIX MEDICAL ASSISTANTS, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-10-07",
        "last_updated": "2020-10-07",
        "certification_date": "2020-10-07",
        "status": "A",
        "authorized_official_last_name": "LUNDGREN",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "PRACTICE ADMINISTRATOR",
        "authorized_official_telephone_number": "817-969-6030"
    },
    "taxonomies": [
        {
            "code": "305S00000X",
            "taxonomy_group": "",
            "desc": "Point of Service",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Matrix Medical Assistants, PLLC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Amanda Ines Matos, MA, LPC
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• Matrix Rehabilitation-Texas, Inc.
• James R Matson, MD

• Point of Service in Dallas, TX
• Providers in Dallas, TX by specialty
• Point of Service in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.