Healthcare Provider Details

I. General information

NPI: 1609953744
Provider Name (Legal Business Name): MATHEWS RENTAL INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/01/2006
Last Update Date: 06/08/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

112 W COLUMBIA STREET
SAN AUGUSTINE TX
75972-0207
US

IV. Provider business mailing address

112 W COLUMBIA STREET P O BOX 207
SAN AUGUSTINE TX
75972-0207
US

V. Phone/Fax

Practice location:
  • Phone: 936-275-3485
  • Fax: 936-275-5424
Mailing address:
  • Phone: 936-275-3485
  • Fax: 936-275-5424

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number0035618
License Number StateTX

VIII. Authorized Official

Name: MRS. SHARON S MATHEWS
Title or Position: SEC/TREA
Credential:
Phone: 936-275-3485