| Matthew Raymond Lussier, MD | |
|
701 Matlock Rd, Mansfield, TX 76063-9164 | |
| (817) 453-5437 | |
| Not Available |
| Full Name | Matthew Raymond Lussier |
|---|---|
| Gender | Male |
| Speciality | Pediatrics |
| Location | 701 Matlock Rd, Mansfield, Texas |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114555182 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208000000X | Pediatrics | U3928 (Texas) | Primary |
| Entity Name | Cook Childrens Physician Network |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1750369203 PECOS PAC ID: 7719884584 Enrollment ID: O20040128000800 |
| Mailing Address | Practice Location Address |
|---|---|
| Matthew Raymond Lussier, MD Po Box 733784, Dallas, TX 75373-3784 Ph: (682) 885-6483 | Matthew Raymond Lussier, MD 701 Matlock Rd, Mansfield, TX 76063-9164 Ph: (817) 453-5437 |
Katrina L Willie-musoma, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 2800 E Broad St Ste 100, Mansfield, TX 76063 Phone: 817-557-5437 Fax: 817-539-0476 | |
Clive G Daniels, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 701 Matlock Rd, Mansfield, TX 76063 Phone: 817-453-5437 Fax: 817-453-2714 | |
Julie Hong, DO Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 1759 Broad Park Circle S, Suite 201 And 205, Mansfield, TX 76063 Phone: 682-341-3910 Fax: 682-400-1288 | |
Linda K Phan, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 252 Matlock Rd Ste 300, Mansfield, TX 76063 Phone: 817-557-5473 Fax: 817-539-0476 | |
Melvin T Joki, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 701 Matlock Rd, Mansfield, TX 76063 Phone: 817-453-5437 Fax: 817-453-2714 | |
Robert W Mann, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 701 Matlock Rd, Mansfield, TX 76063 Phone: 817-453-5437 Fax: 817-453-2714 |