Individual
SOFIA MATA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MAT, LAT, ATC
Contact information
Practice address
206 SHAVER ST, PASADENA, TX 77506-2097
(281) 299-6591
Mailing address
10206 KINGSPOINT RD, HOUSTON, TX 77075-3324
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
ATC7135
TX
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/20/2017
Last updated
12/16/2020
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