Individual provider Active NPI

Terry Ray Mathews, PA-C

  • Physician Assistant
  • San Antonio, TX
National Provider Identifier
1942283924
Registry record updated Sep 18, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
1550 Issued in AZ
Practice address
2261 Hughes Ave Ste 101
San Antonio, TX 78236
Phone
(210) 395-9146
NPI assigned
Nov 23, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 1550 AZ Primary

Addresses

Primary practice location

2261 Hughes Ave Ste 101
San Antonio, TX 78236

Mailing address

2261 Hughes Ave Ste 101
San Antonio, TX 78236-9801
Phone (210) 395-9146

Other practice location 1

300 Twining St Bldg 760
Maxwell AFB, AL 36112-6027
Phone (334) 953-7127

Medicare participation

Medicare enrollment files
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.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1550AZMDOptometrist

NPI Registry JSON

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

{
    "created_epoch": "1132704000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1537228800000",
    "number": "1942283924",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2261 HUGHES AVE STE 101",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782369801",
            "telephone_number": "210-395-9146"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2261 HUGHES AVE STE 101",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "78236",
            "telephone_number": "210-395-9146"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "300 Twining St Bldg 760",
            "address_purpose": "LOCATION",
            "city": "Maxwell AFB",
            "state": "AL",
            "postal_code": "361126027",
            "country_code": "US",
            "telephone_number": "334-953-7127",
            "fax_number": "334-953-3176",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MATHEWS",
        "first_name": "TERRY",
        "middle_name": "RAY",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-23",
        "last_updated": "2018-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "1550",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.