Basic Information
| Provider Information | |||||||||
| NPI: | 1013639368 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | SUSAN MATHEW MD PLLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5311 BELLMONT PARK CT | ||||||||
| Address2: | |||||||||
| City: | SUGAR LAND | ||||||||
| State: | TX | ||||||||
| PostalCode: | 774793662 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7134647555 | ||||||||
| FaxNumber: | 7134903365 | ||||||||
| Practice Location | |||||||||
| Address1: | 9601 KATY FWY STE 270 | ||||||||
| Address2: | |||||||||
| City: | HOUSTON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 770241391 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7134647555 | ||||||||
| FaxNumber: | 7134903365 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/14/2022 | ||||||||
| LastUpdateDate: | 09/14/2022 | ||||||||
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| AuthorizedOfficialLastName: | MATHEW | ||||||||
| AuthorizedOfficialFirstName: | SUSAN | ||||||||
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| AuthorizedOfficialTitleorPosition: | PROVIDER | ||||||||
| AuthorizedOfficialTelephone: | 7134647555 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
| NPICertificationDate: | 09/14/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RR0500X | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | Rheumatology |
No ID Information.