Most Relevant Information
Provider Data
| NPI Number: | 1003406489 |
| Provider Name: | BEENA SUSAN MATHEW |
| Entity Type: | Individual |
| Taxonomy Code: | 363LA2200X |
| Specialty: | Nurse Practitioner |
| License Number: | 1023526 |
Most Important Dates
| Enumeration Date: | 01/20/2021 |
| Last Updated: | 05/11/2022 |
Provider Practice Location
2001 INWOOD RD
DALLAS
TX
753907202
Practice Location Phone/Fax
| Phone: | 2146452800 |
| Fax: | 2146452836 |
Provider Mailing Location
PO BOX 845347
DALLAS
TX
752847208
Provider Mailing Phone/Fax
| Phone: | 2146452800 |
| Fax: | 2146452836 |