Provider Demographics
NPI:1477717858
Name:MATHEWS, REENA RACHEL (MD)
Entity Type:Individual
Prefix:DR
First Name:REENA
Middle Name:RACHEL
Last Name:MATHEWS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1500 S MAIN ST
Mailing Address - Street 2:DEPT. OF FAMILY MEDICINE
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76104-4917
Mailing Address - Country:US
Mailing Address - Phone:817-927-3431
Mailing Address - Fax:
Practice Address - Street 1:3301 STALCUP RD
Practice Address - Street 2:JPS STOP SIX CLINIC
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76119-1726
Practice Address - Country:US
Practice Address - Phone:817-920-7150
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-07-15
Last Update Date:2017-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN4577207Q00000X, 207QG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QG0300XAllopathic & Osteopathic PhysiciansFamily MedicineGeriatric Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine