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Individual

MATHIS T. ADAMS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD PA

Contact information

Practice address
214 SW 26TH AVE, STE A, MINERAL WELLS, TX 76067
(940) 325-7064
(940) 325-7066
Mailing address
214 SW 26TH AVE STE A, MINERAL WELLS, TX 76067-8249
(940) 325-7064
(940) 325-7066

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
L4842
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0034LN
BLUE CROSS BLUE SHIELD
TX
01
8C8812
MEDICARE INDIVIDUAL NUMBE
TX
Enumeration date
07/10/2006
Last updated
10/29/2007
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