Dr. Renjan Roy Mathew, Ph.D.
Psychologist, Clinical in Irving, TX. Individual provider (NPI-1).
NPI number1235549650
StatusActive
Last updated in NPPESMay 23, 2019
Details
- NPI
- 1235549650
- Entity type
- Individual (NPI-1)
- Name
- Dr. Renjan Roy Mathew
- Credential
- Ph.D.
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- May 7, 2014
- Last updated
- May 23, 2019
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 103TC0700X | Psychologist, Clinical | 36436 | TX | Yes |
| 103G00000X | Clinical Neuropsychologist | 36436 | TX |
Practice location
600 E John Carpenter FwySte 291
Irving, TX 75062
Phone 469-444-3226
Mailing address
1636 Santa Anita BlvdIrving, TX 75060-4887
Phone 469-585-5393
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