Individual ProviderRalph MatalonAnesthesiologyAllopathic & Osteopathic PhysiciansPractice Address12222 Merit Dr Ste 600, Dallas, TX 75251-3294(972) 715-5000(210) 615-1187PECOS EnrollmentBased on the most recent information from CMS, provider Ralph Matalon is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.Part BMedicare Part BEnrolledHHAHome Health AgencyEnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records 34 days ago.Profile DetailsProvider ID1063445450Provider TypeIndividualFull NameMatalon, RalphCredentialM.D.GenderMaleSole ProprietorNoEnumeration Date7/8/2006Last Updated6/13/2025Contact InformationPractice LocationPractice Address12222 Merit Dr Ste 600, Dallas, TX 75251-3294Phone(972) 715-5000Fax(972) 715-9976Mailing LocationMailing AddressPO Box 34717, San Antonio, TX 78265-4717Phone(210) 615-1187Fax(210) 314-2180Provider TaxonomiesCodeDescriptionLicenseCode207L00000XPrimaryDescriptionAnesthesiologyAllopathic & Osteopathic PhysiciansLicenseMD-54536IowaCode207L00000XDescriptionAnesthesiologyAllopathic & Osteopathic PhysiciansLicenseJ3152TexasCode207L00000XDescriptionAnesthesiologyAllopathic & Osteopathic PhysiciansLicenseMD217775OregonCode207L00000XDescriptionAnesthesiologyAllopathic & Osteopathic PhysiciansLicense036170304IllinoisProvider IdentifiersIDDescriptionIssuerID1035362-02DescriptionMedicaidIssuerUnlistedTexas