Individual
MRS. MINY K. MATHEW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
4325 N JOSEY LN STE 300, CARROLLTON, TX 75010-4638
(469) 800-4900
(469) 800-4909
Mailing address
2361 SHOREHAM CIR, LEWISVILLE, TX 75056-5592
(972) 899-3146
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA04162
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
315565701
—
TX
Enumeration date
03/03/2009
Last updated
10/11/2019
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