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General NPI Number Information
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NPI Number | 1780953638
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Entity Type | Individual
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Provider Name | SHAWN T MATHEW PHARM D
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Gender | Male
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Dates
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Enumeration Date | 12/21/2011
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Last Update Date | 02/09/2017
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Provider Practice Location Address
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Address Line | 6565 FANNIN ST DB-109 PHARMACY
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City | HOUSTON
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State | TX
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Zip | 77030
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Country | US
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Telephone | 713-441-8911
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Fax |
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Provider Business Mailing Address
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Address Line | 6565 FANNIN DR. DB 109- PHARMACY
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City | HOUSTON
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State | TX
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Zip | 77030
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Country | US
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Telephone |
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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 | 1835P0018X
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Taxonomy Name | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
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License Number | 58222
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 1835P0018X
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Taxonomy Name | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
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License Number | PS48334
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License Number State | FL
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