MEDICARE: ALEYAMMA MATHEW NP-C

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
1	363LF0000X	Family Nurse Practitioner	AP133700	TX

General Provider Information

NPI Number	:	1760911572
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALEYAMMA MATHEW NP-C

Provider Business Mailing Address
First Line	:	941 E PARK ROW DR
Second Line	:
City	:	ARLINGTON
State	:	TX
Zip	:	76010-4508
Country	:	US
Telephone Number	:	817-522-0221
Fax Number	:	817-522-0401

Provider Business Practice Location Address
First Line	:	941 E PARK ROW DR
Second Line	:
City	:	ARLINGTON
State	:	TX
Zip	:	76010-4508
Country	:	US
Telephone Number	:	817-522-0221
Fax Number	:	817-522-0401

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/06/2017
Last Update Date	:	12/11/2025

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