Provider Demographics
NPI:1366988255
Name:MEYERS, MATHIEU (DPT)
Entity type:Individual
Prefix:DR
First Name:MATHIEU
Middle Name:
Last Name:MEYERS
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 8150
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78468-8150
Mailing Address - Country:US
Mailing Address - Phone:361-993-4778
Mailing Address - Fax:361-993-4779
Practice Address - Street 1:2101 AIRLINE RD
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78414-2641
Practice Address - Country:US
Practice Address - Phone:361-993-4778
Practice Address - Fax:361-993-4779
Is Sole Proprietor?:No
Enumeration Date:2017-01-16
Last Update Date:2017-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1276619225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist