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NPI Code Detail

MEDICARE: MARYANN CUNNINGHAM MATHESON NP

MEDICARE: MARYANN CUNNINGHAM MATHESON NP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LG0600XGerontology Nurse PractitionerAP119052TX
2363LP0808XPsychiatric/Mental Health Nurse PractitionerAP119052TX

General Provider Information

NPI Number : 1285958850
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARYANN CUNNINGHAM MATHESON NP
Provider Business Mailing Address
First Line : 5214 ROTHCHILDE CT
Second Line :
City : HOUSTON
State : TX
Zip : 77069-1545
Country : US
Telephone Number : 713-898-8176
Fax Number :
Provider Business Practice Location Address
First Line : 13810 CHAMPION FOREST DR STE 150
Second Line :
City : HOUSTON
State : TX
Zip : 77069-1883
Country : US
Telephone Number : 713-898-5400
Fax Number : 713-597-5857
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/25/2010
Last Update Date : 02/09/2026

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