Most Relevant Information
Provider Data
| NPI Number: | 1003599135 |
| Provider Name: | JORDAN MATTHEW WHEAT MS, LAT, ATC |
| Entity Type: | Individual |
| Taxonomy Code: | 2255A2300X |
| Specialty: | Specialist/Technologist |
| License Number: | AT6192 |
Most Important Dates
| Enumeration Date: | 08/07/2023 |
| Last Updated: | 08/07/2023 |
Provider Practice Location
700 EAGLE DR
DESOTO
TX
751156004
Practice Location Phone/Fax
| Phone: | 9729790527 |
| Fax: |
Provider Mailing Location
4207 HIDEAWAY DR
ARLINGTON
TX
760173300
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |