Individual ProviderMonika MathurFamily MedicineAllopathic & Osteopathic PhysiciansPractice Address909 9th Ave, Suite 300, Fort Worth, TX 76104-3903(817) 336-7191PECOS EnrollmentBased on the most recent information from CMS, provider Monika Mathur 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 ID1689745986Provider TypeIndividualFull NameMathur, MonikaTitleMrs.CredentialMDGenderFemaleSole ProprietorNoEnumeration Date11/10/2006Last Updated5/15/2014Contact InformationPractice LocationPractice Address909 9th Ave, Suite 300, Fort Worth, TX 76104-3903Phone(817) 336-7191Fax(817) 877-4015Mailing LocationMailing Address909 9th Ave, Suite 300, Fort Worth, TX 76104-3903Phone(817) 336-7191Fax(817) 877-4015Provider TaxonomiesCodeDescriptionLicenseCode207Q00000XPrimaryDescriptionFamily MedicineAllopathic & Osteopathic PhysiciansLicenseP3199TexasCode207Q00000XDescriptionFamily MedicineAllopathic & Osteopathic PhysiciansLicense102788MinnesotaCode207Q00000XDescriptionFamily MedicineAllopathic & Osteopathic PhysiciansLicense233621MassachusettsProvider IdentifiersIDDescriptionIssuerIDP00427422DescriptionOtherIssuerMEDICARE RAILROADMinnesotaID307093002DescriptionMedicaidIssuerUnlistedTexasID624457000DescriptionMedicaidIssuerUnlistedMinnesota