Individual
BRENDA MATA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6600 E BEN WHITE BLVD, AUSTIN, TX 78741-7537
(512) 472-4357
(512) 703-1394
Mailing address
1430 COLLIER ST, AUSTIN, TX 78704-2911
(512) 472-4357
(512) 703-1394
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
949442
TX
Other
Enumeration date
06/18/2019
Last updated
06/18/2019
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