Basic Information
| Provider Information | |||||||||
| NPI: | 1679535231 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MATHEWS | ||||||||
| FirstName: | ZEEBA | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2200 W ILLINOIS AVE | ||||||||
| Address2: | |||||||||
| City: | MIDLAND | ||||||||
| State: | TX | ||||||||
| PostalCode: | 797016407 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8006840052 | ||||||||
| FaxNumber: | 4058441794 | ||||||||
| Practice Location | |||||||||
| Address1: | 2200 W ILLINOIS AVE | ||||||||
| Address2: | |||||||||
| City: | MIDLAND | ||||||||
| State: | TX | ||||||||
| PostalCode: | 797016407 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4326865252 | ||||||||
| FaxNumber: | 4326854950 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/06/2006 | ||||||||
| LastUpdateDate: | 06/04/2015 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | MD20060004 | NM | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207R00000X | N6922 | TX | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207RH0002X | N6922 | TX | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Hospice and Palliative Medicine |
ID Information
| ID | Type | State | Issuer | Description | 04381401 | 01 | NM | HOBBS AHCCCS | OTHER | 10506764 | 05 | NM | MEDICAID | P00310620 | 01 | NM | RAILROAD MEDICARE | OTHER | P00398468 | 01 | TX | RAILROAD MEDICARE | OTHER | NM009X77 | 01 | NM | BLUE CROSS BLUE SHIELD | OTHER | 280123501 | 05 | TX | MEDICAID |