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NPI Code Detail

MEDICARE: SHELBIE MATHIS

MEDICARE: SHELBIE MATHIS
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
1225100000XPhysical Therapist1319544TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11319544OTHERTXTEXAS PT LICENSE

General Provider Information

NPI Number : 1932741162
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHELBIE MATHIS
Provider Business Mailing Address
First Line : 23225 KINGSLAND BLVD STE 600
Second Line :
City : KATY
State : TX
Zip : 77494-3705
Country : US
Telephone Number : 281-395-9090
Fax Number :
Provider Business Practice Location Address
First Line : 4225 GUADALUPE ST
Second Line :
City : AUSTIN
State : TX
Zip : 78751-4224
Country : US
Telephone Number : 737-204-0089
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/09/2019
Last Update Date : 10/09/2019

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Directions to “ SHELBIE MATHIS ” Practice Location

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