Individual
BIJU MATHEW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
10350 BANDERA RD STE 140, SAN ANTONIO, TX 78250-5616
(210) 450-6530
(210) 450-2140
Mailing address
10350 BANDERA RD STE 140, SAN ANTONIO, TX 78250-5616
(210) 450-6530
(210) 450-2140
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
AP135843
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
381634003
—
TX
01
—
381634004
CSHCN
TX
Enumeration date
12/05/2017
Last updated
01/17/2020
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