Douglas Mathis, M.D.

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

0101051857 Issued in VA

Practice address

3551 Roger Brooke Dr Apt 7
Jbsa Ft Sam Houston, TX 78234

Phone

(210) 916-4218

NPI assigned

Nov 7, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• University of Texas Health Science Center at San Antonio

  • Internal Medicine Physician
  • San Antonio, TX
  • NPI 1720051717

  Diagnostic Radiology

  NPD

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

{
    "created_epoch": "1131321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568592000000",
    "number": "1790766806",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3551 ROGER BROOKE DR",
            "address_2": "QUALITY SERVICES / 7TH FLOOR ATTN: MCHE-ZQQ",
            "city": "FT SAM HOUSTON",
            "state": "TX",
            "postal_code": "782344504",
            "telephone_number": "210-916-4218"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3551 ROGER BROOKE DR APT 7",
            "city": "JBSA FT SAM HOUSTON",
            "state": "TX",
            "postal_code": "78234",
            "telephone_number": "210-916-4218"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "550 Pope Ave",
            "address_2": "Munson Army Health Center (Attn: Ms Cotton)",
            "address_purpose": "LOCATION",
            "city": "Fort Leavenworth",
            "state": "KS",
            "postal_code": "660272332",
            "country_code": "US",
            "telephone_number": "913-684-6562",
            "fax_number": "913-684-6208",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MATHIS",
        "first_name": "DOUGLAS",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-11-07",
        "last_updated": "2019-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "VA",
            "license": "0101051857",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "US ARMY",
            "identifier": "1790766806",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sheila J Marquez, LCSW
• Rachel Lauren Martin, OD
• Tyler Alan Martin, MD
• Greggory Jose Martinez, M.D.
• Ivana Martos
• Zachary Keith Matthews, MD
• Theresa Ann Mattison, PSY.D.
• Kianna Morning Maxie, X-2
• Claire McCarthy, DO
• Patton Craig McClelland, MD

• Diagnostic Radiology Physician in Jbsa Ft Sam Houston, TX
• Providers in Jbsa Ft Sam Houston, TX by specialty
• Diagnostic Radiology Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.