Individual
JOHANNA MATOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PNP
Contact information
Practice address
7703 FLOYD CURL DR, SAN ANTONIO, TX 78229-3901
(210) 567-9355
(210) 567-5903
Mailing address
7703 FLOYD CURL DR, SAN ANTONIO, TX 78229-3901
(210) 567-9355
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
28160775
IN
363LP0200X
Pediatric Nurse Practitioner
6873536
TX
363LP0200X
Pediatric Nurse Practitioner
71003123
IN
363LP0200X
Pediatric Nurse Practitioner
Primary
AP121172
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
080462703
—
TX
05
—
200966730
—
IN
05
—
327258503
—
TX
01
—
327258504
CSHCN
TX
Enumeration date
10/20/2009
Last updated
05/18/2017
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