Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 036.146950 | IL |
N | 111NI0900X | Internist | 036.146950 | IL |
N | 207R00000X | Internist | S3021 | TX |
N | 111NI0900X | Internist | S3021 | TX |
NPI | 1003200700 |
---|---|
Provider Name | Susan Mathew |
First Address | Houston, TX 77025-2419 |
Second Address | Sugar Land, TX 77479-4728 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/03/2015 |
Last Update Date | 04/02/2022 |