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Individual

DAVID MATA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
1115 E MAIN ST, ALICE, TX 78332-5046
(361) 664-1344
Mailing address
314 E SANTA GERTRUDIS ST, KINGSVILLE, TX 78363-4532

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
74319
TX

Other

Enumeration date
07/26/2024
Last updated
07/26/2024
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