Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | H8240 | TX |
N | 111NI0900X | Internist | H8240 | TX |
Y | 207RH0002X | Hospice and Palliative Medicine | H8240 | TX |
NPI | 1215992888 |
---|---|
Provider Name | Alvin J Mathe |
First Address | Fort Worth, TX 76104-2122 |
Second Address | Fort Worth, TX 76104-2122 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/04/2006 |
Last Update Date | 02/04/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
110092972 | RAILROAD MEDICARE (01) | TX |
129828305 | (05) | TX |
842594 | BCBS (01) | TX |
F13541 | (02) | TX |