Individual
MISS HENRIETTE MERCEDES MATHIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1615 OSPREY DR STE 107, DESOTO, TX 75115-2427
(469) 930-5842
(866) 315-5210
Mailing address
P.O. BOX 845347, DALLAS, TX 75284-5347
(214) 648-9741
(214) 648-9531
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
P9647
TX
208M00000X
Hospitalist Physician
Primary
P9647
TX
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/12/2011
Last updated
06/17/2025
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