Individual
AMANDA MATA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
100 E RIDGE RD STE A, MCALLEN, TX 78503-1346
(956) 682-1888
(956) 661-2207
Mailing address
PO BOX 4449, MCALLEN, TX 78502-4449
(956) 682-1888
(956) 661-2207
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
F04170401
TX
Other
Enumeration date
05/19/2017
Last updated
07/23/2018
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