Provider Demographics
NPI:1184435612
Name:MATHEW, JUDY MARIAM (PHARMD)
Entity type:Individual
Prefix:
First Name:JUDY
Middle Name:MARIAM
Last Name:MATHEW
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 1:4427 PELOTON RD
Mailing Address - Street 2:
Mailing Address - City:MANVEL
Mailing Address - State:TX
Mailing Address - Zip Code:77578-1763
Mailing Address - Country:US
Mailing Address - Phone:713-291-5738
Mailing Address - Fax:
Practice Address - Street 1:101 SOUTHWESTERN BLVD STE 100
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77478-3548
Practice Address - Country:US
Practice Address - Phone:832-939-3550
Practice Address - Fax:832-939-3560
Is Sole Proprietor?:No
Enumeration Date:2025-01-15
Last Update Date:2025-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX67649183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist