Provider Demographics
NPI:1477988475
Name:MATHAI, SHEEBA R (FNP-BC)
Entity Type:Individual
Prefix:
First Name:SHEEBA
Middle Name:R
Last Name:MATHAI
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 STONEBROOK PKWY UNIT 201
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75036-1181
Mailing Address - Country:US
Mailing Address - Phone:972-787-2710
Mailing Address - Fax:214-387-1889
Practice Address - Street 1:400 STONEBROOK PKWY UNIT 201
Practice Address - Street 2:
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75036-1181
Practice Address - Country:US
Practice Address - Phone:972-787-2710
Practice Address - Fax:214-387-1889
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-09
Last Update Date:2023-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX661899163W00000X
TXAP123519363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX013956OtherPRESCRIPTION ID NUMBER