MEDICARE: HEATHER MATHIS

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	235Z00000X	Speech-Language Pathologist	100952	TX

General Provider Information

NPI Number	:	1659644599
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HEATHER MATHIS

Provider Business Mailing Address
First Line	:	811 S INTERURBAN ST STE B
Second Line	:
City	:	ANNA
State	:	TX
Zip	:	75409-3626
Country	:	US
Telephone Number	:	972-441-2434
Fax Number	:

Provider Business Practice Location Address
First Line	:	811 S INTERURBAN ST STE B
Second Line	:
City	:	ANNA
State	:	TX
Zip	:	75409-3626
Country	:	US
Telephone Number	:	972-441-2434
Fax Number	:

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

Provider Enumeration Date	:	02/22/2012
Last Update Date	:	02/12/2026

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Directions to “ HEATHER MATHIS ” Practice Location

Language	Start Address	Practice Location

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