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NPI Code Detail

MEDICARE: MICHELLE ANN MATHEW DO

MEDICARE: MICHELLE ANN MATHEW DO
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1215632823
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHELLE ANN MATHEW DO
Provider Business Mailing Address
First Line : 5205 TOPAZ CT
Second Line :
City : FLOWER MOUND
State : TX
Zip : 75022-8143
Country : US
Telephone Number : 972-310-1491
Fax Number :
Provider Business Practice Location Address
First Line : 5323 HARRY HINES BLVD
Second Line :
City : DALLAS
State : TX
Zip : 75390-7201
Country : US
Telephone Number : 214-648-3111
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/03/2023
Last Update Date : 03/13/2026

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