Provider Demographics
NPI:1174516165
Name:STRANGE, MATTHEW G (MD)
Entity type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:G
Last Name:STRANGE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 COWBOYS WAY
Mailing Address - Street 2:STE 150
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75034-1995
Mailing Address - Country:US
Mailing Address - Phone:214-647-6165
Mailing Address - Fax:214-647-6166
Practice Address - Street 1:1441 RIDGE ST
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34103-4211
Practice Address - Country:US
Practice Address - Phone:239-643-1155
Practice Address - Fax:239-643-9816
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-25
Last Update Date:2019-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN96492085R0202X
FLME922912085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLI36693Medicare UPIN
FL16291Medicare ID - Type Unspecified