Provider Demographics
NPI:1093021040
Name:MATHEW, JULIE JOY (OD)
Entity Type:Individual
Prefix:DR
First Name:JULIE
Middle Name:JOY
Last Name:MATHEW
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:JULIE
Other - Middle Name:ANN
Other - Last Name:JOY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1811 N GREENVILLE AVE APT 2215
Mailing Address - Street 2:
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75081-2034
Mailing Address - Country:US
Mailing Address - Phone:832-865-6367
Mailing Address - Fax:
Practice Address - Street 1:3060 FM 407 STE 2
Practice Address - Street 2:
Practice Address - City:HIGHLAND VILLAGE
Practice Address - State:TX
Practice Address - Zip Code:75077-7047
Practice Address - Country:US
Practice Address - Phone:972-906-8822
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-27
Last Update Date:2018-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX7647T152W00000X
TX7647152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty