Provider Demographics
NPI:1598854515
Name:MATHYS, MONICA LOUISE (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:MONICA
Middle Name:LOUISE
Last Name:MATHYS
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:719 FOX RUN CT
Mailing Address - Street 2:
Mailing Address - City:MURPHY
Mailing Address - State:TX
Mailing Address - Zip Code:75094-4136
Mailing Address - Country:US
Mailing Address - Phone:972-424-9676
Mailing Address - Fax:
Practice Address - Street 1:4500 S. LANCASTER RD
Practice Address - Street 2:DALLAS VA MEDICAL CENTER
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75216
Practice Address - Country:US
Practice Address - Phone:214-372-5300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX44020183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist