Individual
DEEPA MARY MATHEW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
1719 SHAWNEE TRAIL, ALLEN, TX 75002
(972) 971-9216
Mailing address
1719 SHAWNEE TRAIL, ALLEN, TX 75002
(972) 971-9216
Taxonomy
Speciality
Code
Description
License number
State
163WS0200X
School Registered Nurse
Primary
712388
PA
Other
Enumeration date
01/15/2020
Last updated
01/15/2020
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