Active NPI
Stephanie Marie Matheu, MD
- Student in an Organized Health Care Education/Training Program
- San Antonio, TX
National Provider Identifier
1639744121
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Student in an Organized Health Care Education/Training Program
- License
- BP10081097
- Practice address
- 4502 Medical Dr
San Antonio, TX 78229-4402 - Phone
- (210) 358-4000
- NPI assigned
- May 26, 2021
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | 15732-I | PR | |
| Student in an Organized Health Care Education/Training Program | 390200000X | BP10081097 | TX | Primary |
Addresses
Primary practice location
4502 Medical Dr
San Antonio, TX 78229-4402
Mailing address
4502 Medical Dr
San Antonio, TX 78229-4402
Phone (210) 358-4000
Other practice location 1
Avenida Severiano Cuevas
18 Km. 141.1 Bo. Caimital Baj
Aguadilla, PR 00603
Phone (787) 658-0000 ext. 1019
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 |
|---|---|---|---|
| 15732-I | PR | MD | Student in an Organized Health Care Education/Training Program |
| BP10081097 | TX | MD | Student in an Organized Health Care Education/Training Program |
Interoperability endpoints
- stephanie.matheu@wellmed.eclinicaldirectplus.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1621987200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1743638400000",
"number": "1639744121",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4502 MEDICAL DR",
"city": "SAN ANTONIO",
"state": "TX",
"postal_code": "782294402",
"telephone_number": "210-358-4000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4502 MEDICAL DR",
"city": "SAN ANTONIO",
"state": "TX",
"postal_code": "782294402",
"telephone_number": "210-358-4000"
}
],
"practiceLocations": [
{
"address_1": "Avenida Severiano Cuevas",
"address_2": "18 Km. 141.1 Bo. Caimital Baj",
"address_purpose": "LOCATION",
"city": "Aguadilla",
"state": "PR",
"postal_code": "00603",
"country_code": "US",
"telephone_number": "787-658-0000 x1019",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MATHEU",
"first_name": "STEPHANIE",
"middle_name": "MARIE",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-05-26",
"last_updated": "2025-04-03",
"certification_date": "2025-04-03",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "PR",
"license": "15732-I",
"primary": false
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "TX",
"license": "BP10081097",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in San Antonio, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.