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Organization
WAVERLY PRIMARY CARE, PLLC
Active
Organization
WAVERLY PRIMARY CARE, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KRISTINA MATA FNP-C (OWNER, AUTHORIZED OFFICIAL)
(936) 284-2055
Entity
Organization
Contact information
Practice address
9329 STATE HWY 75, NEW WAVERLY, TX 77358
(936) 284-2055
Mailing address
24 LONG HORN LOOP, NEW WAVERLY, TX 77358-3735
(936) 284-2055
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
—
—
Other
Enumeration date
04/24/2020
Last updated
04/24/2020
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