Individual provider Active NPI

Marylyn Liswin Mathew

  • Psychiatry Physician
  • Temple, TX
National Provider Identifier
1871097469
Registry record updated Oct 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
T7647 Issued in TX
Practice address
1901 SW H K Dodgen Loop BLDG 300
Temple, TX 76502-1814
Phone
(254) 724-5437
NPI assigned
Mar 20, 2018
Last updated
Oct 26, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 26, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Psychiatry Physician 2084P0800X T7647 TX Primary

Addresses

Primary practice location

1901 SW H K Dodgen Loop BLDG 300
Temple, TX 76502-1814

Mailing address

PO Box 844658
Dallas, TX 75284-4658
Phone (800) 994-0371

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mmathew71850@direct.sw.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230830004327 TX Practitioner - Psychiatry 2466851837 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Scott & White Clinic Psychiatry Current Accepting new patients
Scott & White Clinic Psychiatry CurrentSince Aug 16, 2023 Accepting new patients

Locations

101 Lafferty Ave
Cameron, TX 76520
Phone (254) 605-1100

1901 SW H K Dodgen Loop
Bldg 300
Temple, TX 76502
Phone (254) 935-4888

2401 S 31st St
Temple, TX 76508
Phone (254) 724-2459

2401 S 31st St
#22117D
Temple, TX 76508
Phone (254) 724-1768

Interoperability endpoints

  • Direct secure messaging: mmathew71850@direct.sw.org

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1521504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698278400000",
    "number": "1871097469",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 844658",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752844658",
            "telephone_number": "800-994-0371"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1901 SW H K DODGEN LOOP BLDG 300",
            "city": "TEMPLE",
            "state": "TX",
            "postal_code": "765021814",
            "telephone_number": "254-724-5437"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATHEW",
        "first_name": "MARYLYN",
        "middle_name": "LISWIN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-03-20",
        "last_updated": "2023-10-26",
        "certification_date": "2023-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "TX",
            "license": "T7647",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mmathew71850@direct.sw.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1901 SW H K Dodgen Loop Bldg 300",
            "city": "Temple",
            "state": "TX",
            "country_code": "US",
            "postal_code": "765021814",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Temple, TX

Sources for this page

Verify at the official NPI Registry.