Individual
LISA PHILIP MATHEW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
1902 WINDSOR PL STE 102, FORT WORTH, TX 76110-1866
(682) 207-1700
(682) 250-5246
Mailing address
1902 WINDSOR PL STE 102, FORT WORTH, TX 76110-1866
(682) 207-1700
(682) 250-5246
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
AP124548
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
328172704
—
TX
Enumeration date
09/04/2013
Last updated
03/25/2021
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