Provider Demographics
NPI:1417105487
Name:RITESH A. MATHUR M.D., P.A
Entity Type:Organization
Organization Name:RITESH A. MATHUR M.D., P.A
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RITESH
Authorized Official - Middle Name:AMJANI
Authorized Official - Last Name:MATHUR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:832-532-7756
Mailing Address - Street 1:4780 SWEETWATER BLVD
Mailing Address - Street 2:STE 100
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77479-3163
Mailing Address - Country:US
Mailing Address - Phone:832-532-7756
Mailing Address - Fax:832-532-7757
Practice Address - Street 1:4780 SWEETWATER BLVD
Practice Address - Street 2:STE 100
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77479-3163
Practice Address - Country:US
Practice Address - Phone:832-532-7756
Practice Address - Fax:832-532-7757
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-03
Last Update Date:2014-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM3315207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXM3315OtherMEDICAL LICENSE
TXM3315OtherMEDICAL LICENSE