Basic Information
| Provider Information | |||||||||
| NPI: | 1891727129 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MATHEW | ||||||||
| FirstName: | PAUL | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4849 N MESA ST STE 201 | ||||||||
| Address2: | |||||||||
| City: | EL PASO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 799125919 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9153516600 | ||||||||
| FaxNumber: | 9153516601 | ||||||||
| Practice Location | |||||||||
| Address1: | 2000 TRANSMOUNTAIN RD | ||||||||
| Address2: | |||||||||
| City: | EL PASO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 799113601 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9152478893 | ||||||||
| FaxNumber: | 9153516600 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/07/2006 | ||||||||
| LastUpdateDate: | 01/19/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 06/30/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | P1568 | TX | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207R00000X | MD2011-0243 | NM | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207R00000X | 37325 | AZ | N | Allopathic & Osteopathic Physicians | Internal Medicine | 208M00000X | P1568 | TX | Y | Allopathic & Osteopathic Physicians | Hospitalist |
ID Information
| ID | Type | State | Issuer | Description | P01249699 | 01 | TX | RAILROAD RETIREMENT MEDICARE | OTHER | 2967929-01 | 05 | TX | MEDICAID | 8DZ192 | 01 | TX | BC/BS OF TEXAS | OTHER |