Individual
MR. MARIO DAVID MATA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LSA
Contact information
Practice address
7401 MAIN ST, HOUSTON, TX 77030-4509
(713) 799-2300
(833) 520-1440
Mailing address
14110 HARTFORD HEIGHTS WAY, ROSHARON, TX 77583-1978
(713) 315-1519
Taxonomy
Speciality
Code
Description
License number
State
246ZC0007X
Surgical Assistant
Primary
SA00462
TX
363AS0400X
Surgical Physician Assistant
Primary
SA00462
TX
Other
Enumeration date
07/23/2012
Last updated
05/12/2026
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