Provider Demographics
NPI:1235134404
Name:MATHAI, SHERLY RAJU (RPH)
Entity Type:Individual
Prefix:MRS
First Name:SHERLY
Middle Name:RAJU
Last Name:MATHAI
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:MRS
Other - First Name:SHERLY
Other - Middle Name:RAJU
Other - Last Name:MATHAI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RPH
Mailing Address - Street 1:8722 BEXAR DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77064-7425
Mailing Address - Country:US
Mailing Address - Phone:281-897-0546
Mailing Address - Fax:
Practice Address - Street 1:8722 BEXAR DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77064-7425
Practice Address - Country:US
Practice Address - Phone:281-897-0546
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-06-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX34097183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist