Jordan Abraham Mathew, PHARM D

Primary specialty

PharmacistTaxonomy code 183500000X

License

69614 Issued in TX

Practice address

3605 College St
Beaumont, TX 77701-4617

Phone

(409) 832-7374

NPI assigned

Mar 14, 2022

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Walgreen Co

  • Pharmacy
  • Beaumont, TX
  • NPI 1134134182
  NPD (past)
• Walgreen Co

  • Pharmacy
  • Longview, TX
  • NPI 1629956545
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1647216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647216000000",
    "number": "1205584869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4215 N MAJOR DR APT 408",
            "city": "BEAUMONT",
            "state": "TX",
            "postal_code": "777139622"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3605 COLLEGE ST",
            "city": "BEAUMONT",
            "state": "TX",
            "postal_code": "777014617",
            "telephone_number": "409-832-7374"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATHEW",
        "first_name": "JORDAN",
        "middle_name": "ABRAHAM",
        "name_prefix": "Dr.",
        "credential": "PHARM D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-03-14",
        "last_updated": "2022-03-14",
        "certification_date": "2022-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "TX",
            "license": "69614",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DRIVERS LICENSE ID #",
            "identifier": "36551416",
            "state": "TX"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rxm.03821@store.walgreens.com",
            "affiliation": "N",
            "endpointDescription": "store email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Store use",
            "address_1": "3605 College St",
            "city": "Beaumont",
            "state": "TX",
            "country_code": "US",
            "postal_code": "777014617",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Mary L. Olsen, M.D., P.a.
• Anquinetta Monique Mason-Baylor, COTA/L
• Massage Therapy Education Center
• Jason Earl Matherne, M.D.
• Robert Charles Matherne, D.D.S.
• Kiera Mattern
• Mackeinzie Alyse Matthews
• Maxie C Sprott II MD PA
• Maxim Healthcare Services, Inc.
• Caitlin Leann May, SLP

• Pharmacist in Beaumont, TX
• Providers in Beaumont, TX by specialty
• Pharmacist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.