| Roy J Mathew Mdpa | |
|
600 N Marienfeld St Ste 308 Midland TX 79701-4395 | |
| (432) 617-3855 | |
| (432) 617-3840 |
| Full Name | Roy J Mathew Mdpa |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 600 N Marienfeld St, Midland, Texas |
| Authorized Official Name and Position | Roy J Mathew (PRESIDENT) |
| Authorized Official Contact | 4326173855 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Roy J Mathew Mdpa 6810 Island Cir # 1 Midland TX 79707-1413 Ph: (432) 617-3855 | Roy J Mathew Mdpa 600 N Marienfeld St Ste 308 Midland TX 79701-4395 Ph: (432) 617-3855 |
| NPI Number | 1740403120 |
|---|---|
| Provider Enumeration Date | 04/11/2007 |
| Last Update Date | 04/20/2008 |
| Medicare PECOS PAC ID | 5294756300 |
|---|---|
| Medicare Enrollment ID | O20051215000756 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740403120 | NPI | - | NPPES |
| 0008NH | Other | TX | BCBS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | E6496 (Texas) | Primary |
| Provider Name | Roy J Mathew |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1801992920 PECOS PAC ID: 6305813387 Enrollment ID: I20040910000829 |
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