MEDICARE: DR. SUSAN MATHEW M .D.

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
1	174400000X	Specialist	195387	PA
2	207RR0500X	Rheumatology Physician	P8156	TX

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	392210YN34	OTHER	TX	MEDICARE
3	392210ZL0W	OTHER	TX	MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	8HY593	OTHER	TX	BLUE CROSS BLUE SHIELD

General Provider Information

NPI Number	:	1356651244
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SUSAN MATHEW M .D.

Provider Business Mailing Address
First Line	:	7102 TARRINGTON AVE STE 703
Second Line	:
City	:	SUGAR LAND
State	:	TX
Zip	:	77479-7281
Country	:	US
Telephone Number	:	281-980-2717
Fax Number	:	281-265-3806

Provider Business Practice Location Address
First Line	:	7102 TARRINGTON AVE STE 703
Second Line	:
City	:	SUGAR LAND
State	:	TX
Zip	:	77479-7281
Country	:	US
Telephone Number	:	281-980-2717
Fax Number	:	281-265-3806

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/14/2010
Last Update Date	:	03/12/2026

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Directions to “ DR. SUSAN MATHEW M .D.” Practice Location

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