Active NPI
Annamma T Mathew, M.D
- Neurology Physician
- Waco, TX
National Provider Identifier
1508873365
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neurology Physician
- License
- 9304
- Practice address
- VA Medical Center
4800 Memorial Drive
Waco, TX 76711-0000 - Phone
- (254) 297-3000
- NPI assigned
- Aug 2, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Neurology Physician | 2084N0400X | 9304 | DC | Primary |
Addresses
Primary practice location
VA Medical Center
4800 Memorial Drive
Waco, TX 76711-0000
Mailing address
202 Canyon Point Cir
Waco, TX 76712-3828
Phone (254) 772-1499
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 9304 | DC | MD | Neurology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154476800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1508873365",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "202 CANYON POINT CIR",
"city": "WACO",
"state": "TX",
"postal_code": "767123828",
"telephone_number": "254-772-1499"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "VA MEDICAL CENTER",
"address_2": "4800 MEMORIAL DRIVE",
"city": "WACO",
"state": "TX",
"postal_code": "767110000",
"telephone_number": "254-297-3000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MATHEW",
"first_name": "ANNAMMA",
"middle_name": "T",
"name_prefix": "Dr.",
"credential": "M.D",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-02",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "2084N0400X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Neurology",
"state": "DC",
"license": "9304",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Waco, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.