Healthcare Provider Details

I. General information

NPI: 1104697242
Provider Name (Legal Business Name): ALEENA MATHEW DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/09/2024
Last Update Date: 01/09/2024
Certification Date: 01/09/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13440 UNIVERSITY BLVD STE 210
SUGAR LAND TX
77479-7218
US

IV. Provider business mailing address

5203 PEBBLE BLUFF LN
SUGAR LAND TX
77479-3393
US

V. Phone/Fax

Practice location:
  • Phone: 281-277-1330
  • Fax:
Mailing address:
  • Phone: 281-832-0145
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number1387283
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: