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Winfred Kemunto Matonda

Family Medicine

Allopathic & Osteopathic Physicians

1301 Pennsylvania Ave, Fort Worth, TX 76104-2122

PECOS Enrollment

This provider is enrolled in PECOS as WINFRED MATONDA.

Based on the most recent information from CMS, provider Winfred Kemunto Matonda is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records 3 days ago.

Profile Details

Provider ID
1144853797
Provider Type
Individual
Full Name
Matonda, Winfred Kemunto
Title
Mrs.

Gender
Female
Sole Proprietor
No
Enumeration Date
2/21/2020
Last Updated
2/21/2020

Contact Information

Practice Location

1301 Pennsylvania Ave, Fort Worth, TX 76104-2122

(817) 250-2661

Unlisted Fax

Mailing Location

1301 Pennsylvania Ave, Fort Worth, TX 76104-2122

(817) 250-2661

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 207Q00000X Primary	Description Family Medicine Allopathic & Osteopathic Physicians	License AP144055 Texas

Winfred Kemunto Matonda

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Tran, Margaret

Vilaythong, Alexander P.

Amber Rogers, Md, Pllc

Autry, Heather Lynn

Nguyen, Jennifer Phuong-Loan

Lasater, Loren S

Zeiser, Michael Jonathan

Thomas, Lini M

Komorian, Amber Nicole

Martin A. Derusha, Jr., D.O,, P.A.