Individual ProviderNancy J MathisFamily MedicineAllopathic & Osteopathic PhysiciansPractice Address1307 8th Ave, Suite 311, Fort Worth, TX 76104-4137(817) 226-8884(817) 294-7444PECOS EnrollmentBased on the most recent information from CMS, provider Nancy J Mathis does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 3 days ago.Profile DetailsProvider ID1447367859Provider TypeIndividualFull NameMathis, Nancy JCredentialMDGenderFemaleSole ProprietorYesEnumeration Date8/23/2006Last Updated8/5/2008Contact InformationPractice LocationPractice Address1307 8th Ave, Suite 311, Fort Worth, TX 76104-4137Phone(817) 226-8884FaxUnlisted FaxMailing LocationMailing AddressPO Box 2626, Fort Worth, TX 76113-2626Phone(817) 294-7444FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode207Q00000XPrimaryDescriptionFamily MedicineAllopathic & Osteopathic PhysiciansLicenseE7182TexasProvider IdentifiersIDDescriptionIssuerID0004MPDescriptionOtherIssuerBCBSTexasID174681001DescriptionMedicaidIssuerUnlistedTexas