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General NPI Number Information
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NPI Number | 1750595625
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Entity Type | Individual
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Provider Name | NISHA MATHEWS M.P.T, D.P.T
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Gender | Female
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Dates
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Enumeration Date | 05/10/2007
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Last Update Date | 09/29/2015
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Provider Practice Location Address
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Address Line | 1625 THOMAS LN
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City | CARROLLTON
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State | TX
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Zip | 75010-3242
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Country | US
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Telephone | 917-657-0888
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Fax |
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Provider Business Mailing Address
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Address Line | 1625 THOMAS LN
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City | CARROLLTON
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State | TX
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Zip | 75010-3242
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Country | US
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Telephone | 917-657-0888
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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 | 2251X0800X
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Taxonomy Name | Orthopedic Physical Therapist
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License Number | 1205207
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 1205207
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License Number State | TX
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