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Individual
LIJI ANN MATHEW
Active
Individual
LIJI ANN MATHEW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
AP1008907
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1008907
MEDICAL LICENSE
TX
01
—
23157422
TEXAS DL NUMBER
TX
Enumeration date
11/17/2021
Last updated
11/14/2023
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