Provider Demographics
NPI:1306906458
Name:MATHEWS, THOMAS JOHN (RPH)
Entity type:Individual
Prefix:MR
First Name:THOMAS
Middle Name:JOHN
Last Name:MATHEWS
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:2623 OLD STABLES DR
Mailing Address - Street 2:
Mailing Address - City:CELINA
Mailing Address - State:TX
Mailing Address - Zip Code:75009-4674
Mailing Address - Country:US
Mailing Address - Phone:972-382-8014
Mailing Address - Fax:800-874-9179
Practice Address - Street 1:10530 JOHN W. ELLIOTT DRIVE
Practice Address - Street 2:SUITE 100
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75034
Practice Address - Country:US
Practice Address - Phone:214-387-3500
Practice Address - Fax:800-874-9179
Is Sole Proprietor?:No
Enumeration Date:2006-12-11
Last Update Date:2013-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX32678183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist