Provider Demographics
NPI:1952539488
Name:MATHEWS, SHIRLEY REBECCA (MD)
Entity Type:Individual
Prefix:
First Name:SHIRLEY
Middle Name:REBECCA
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 1:2380 FIREWHEEL PKWY
Mailing Address - Street 2:STE 100
Mailing Address - City:GARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:75040-4004
Mailing Address - Country:US
Mailing Address - Phone:972-864-0252
Mailing Address - Fax:
Practice Address - Street 1:2380 FIREWHEEL PKWY
Practice Address - Street 2:
Practice Address - City:GARLAND
Practice Address - State:TX
Practice Address - Zip Code:75040
Practice Address - Country:US
Practice Address - Phone:972-864-0252
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-06-23
Last Update Date:2015-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN3874207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine