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General NPI Number Information
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NPI Number | 1164128591
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Entity Type | Individual
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Provider Name | RIBI CHERIAN MATHEW AGNP-C
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Gender | Female
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Dates
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Enumeration Date | 02/07/2023
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Last Update Date | 02/07/2023
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Provider Practice Location Address
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Address Line | 10423 TX-151 STE 103
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City | SAN ANTONIO
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State | TX
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Zip | 78251
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Country | US
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Telephone | 210-816-8066
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Fax |
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Provider Business Mailing Address
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Address Line | 7522 COPPER MDW
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City | CONVERSE
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State | TX
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Zip | 78109-3941
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Country | US
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Telephone | 832-436-3635
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number | 1109294
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 363LG0600X
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Taxonomy Name | Gerontology Nurse Practitioner
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License Number | 1109294
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License Number State | TX
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