Individual
PROF. BEENA SUSAN MATHEW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2001 INWOOD RD, DALLAS, TX 75390-7202
(214) 645-2800
(214) 645-2836
Mailing address
PO BOX 845347, DALLAS, TX 75284-7208
(214) 645-2800
(214) 645-2836
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
1023526
TX
363LA2200X
Adult Health Nurse Practitioner
1023526
TX
Other
Enumeration date
01/20/2021
Last updated
05/11/2022
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