Doctor Name: | VIMALA MATHEW |
NPI Number: | 1053324657 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | RN |
License Number: | 656974 |
Business Practice Address: | 2002 Holcombe ,houston,texas 5807 Martinique Pass Sugarland, TX - 77479 |
Business Phone Number: | 2812776646 |
Business Fax Number: | |
Mailing Address: | 5807 Martinique Pass, SUGAR LAND |
State: | TX |
Postal Code: | 774794159 |
Phone Number: | 2812776646 |
Fax Number: | |
NPI Enumeration Date: | 08/14/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 163WP0808X |
License Number: | 656974 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TX |
Taxonomy Type: | Nursing Service Providers |
Taxonomy Classification: | Registered Nurse |
Taxonomy Specialization: | Psych/Mental Health |
Taxonomy Definition: |