Provider Demographics
NPI:1083453765
Name:MATHEW, GEMI MARY
Entity type:Individual
Prefix:
First Name:GEMI
Middle Name:MARY
Last Name:MATHEW
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5305 CREEK CT
Mailing Address - Street 2:
Mailing Address - City:GARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:75043-3149
Mailing Address - Country:US
Mailing Address - Phone:214-743-0573
Mailing Address - Fax:
Practice Address - Street 1:18081 MIDWAY RD APT 2638
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75287-6569
Practice Address - Country:US
Practice Address - Phone:214-743-0573
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-22
Last Update Date:2024-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker