Provider Demographics
NPI:1265866321
Name:A.J. MATHEWS, INC.
Entity Type:Organization
Organization Name:A.J. MATHEWS, INC.
Other - Org Name:STAR WELLNESS TEXAS PANHANDLE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JILL
Authorized Official - Middle Name:A
Authorized Official - Last Name:MATHEWS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:806-331-7969
Mailing Address - Street 1:PO BOX 2665
Mailing Address - Street 2:
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79105-2665
Mailing Address - Country:US
Mailing Address - Phone:806-331-7969
Mailing Address - Fax:806-468-9542
Practice Address - Street 1:1102 I-40 W
Practice Address - Street 2:
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79102-2667
Practice Address - Country:US
Practice Address - Phone:806-331-7969
Practice Address - Fax:806-468-9542
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-26
Last Update Date:2013-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QC1800XAmbulatory Health Care FacilitiesClinic/CenterCorporate Health