| Organization Name: | MATLOCK FAMILY CLINIC, P.A. |
| NPI Number: | 1710167713 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | MAI V.Q HOANG (DOCTOR) |
| Mailing Address: | 4045 E Belknap St #12 Haltom City |
| State: | TX US |
| Postal Code: | 761116638 |
| Phone Number: | 8177592315 |
| Fax Number: | 8177592316 |
| NPI Enumeration Date: | 11/07/2007 |
| NPI Last Update Date: | 11/07/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QP2300X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Primary Care |
| Taxonomy Definition: | |