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Individual
RUBEN MATA
Active
Individual
RUBEN MATA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
FNP
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
257185
TX
363LF0000X
Family Nurse Practitioner
Primary
AP127306
TX
Other
Enumeration date
03/02/2015
Last updated
07/16/2015
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