MEDICARE: ANJU ANN MATHEWS AGACNP-BC

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	363LA2100X	Acute Care Nurse Practitioner	1180879	TX

General Provider Information

NPI Number	:	1437011962
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANJU ANN MATHEWS AGACNP-BC

Provider Business Mailing Address
First Line	:	6124 W PARKER RD STE 432
Second Line	:
City	:	PLANO
State	:	TX
Zip	:	75093-8124
Country	:	US
Telephone Number	:	972-403-3100
Fax Number	:	972-403-3105

Provider Business Practice Location Address
First Line	:	6124 W PARKER RD STE 432
Second Line	:
City	:	PLANO
State	:	TX
Zip	:	75093-8124
Country	:	US
Telephone Number	:	972-403-3100
Fax Number	:	972-403-3105

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

Provider Enumeration Date	:	12/02/2025
Last Update Date	:	12/15/2025

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