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Individual
MR. THOMAS MATHEW
Active
Individual
MR. THOMAS MATHEW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1081537
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1081537
PHYSICAL THERAPY LICENSE
TX
01
—
650546
BCBS ID
TX
Enumeration date
02/05/2007
Last updated
10/29/2007
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