MEDICARE: ANITHA PAUL MATHEW

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	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	1136717	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1841057809
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANITHA PAUL MATHEW

Provider Business Mailing Address
First Line	:	285 MORNING FOG LN
Second Line	:
City	:	SUNNYVALE
State	:	TX
Zip	:	75182-2611
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4817 MEDICAL CENTER DR
Second Line	:	STE 3B
City	:	MCKINNEY
State	:	TX
Zip	:	75069
Country	:	US
Telephone Number	:	405-822-2136
Fax Number	:

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

Provider Enumeration Date	:	03/05/2024
Last Update Date	:	03/19/2026

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