Healthcare Provider Details

I. General information

NPI: 1477557981
Provider Name (Legal Business Name): JEYA VARKEY MATHEWS RPH
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 06/13/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

39 HIGHCLERE PARK DR
SPRING TX
77379-7245
US

IV. Provider business mailing address

39 HIGHCLERE PARK DR
SPRING TX
77379-7245
US

V. Phone/Fax

Practice location:
  • Phone: 713-320-4644
  • Fax: 713-495-3717
Mailing address:
  • Phone: 713-320-4644
  • Fax: 713-495-3717

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number36047
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: