Provider Demographics
NPI:1548759897
Name:MATHEW, SHARON JOSE (DPM)
Entity type:Individual
Prefix:
First Name:SHARON
Middle Name:JOSE
Last Name:MATHEW
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:13636 BRETON RIDGE ST STE D
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77070-6077
Mailing Address - Country:US
Mailing Address - Phone:281-937-4546
Mailing Address - Fax:346-998-1661
Practice Address - Street 1:13636 BRETON RIDGE ST STE D
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77070-6077
Practice Address - Country:US
Practice Address - Phone:281-937-4546
Practice Address - Fax:346-998-1661
Is Sole Proprietor?:No
Enumeration Date:2018-05-02
Last Update Date:2024-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX692170213ES0103X
NJ25MD00361200213E00000X, 213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
No213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist