Individual
MRS. BETHANY AWBREY MATA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD, LD
Contact information
Practice address
4801 ALBERTA AVE, EL PASO, TX 79905-2707
(915) 215-5700
(915) 215-8872
Mailing address
440 RAYNOLDS ST # 51015, EL PASO, TX 79905-1613
(915) 215-4480
(915) 215-5386
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
DT83064
TX
Other
Enumeration date
02/05/2014
Last updated
09/13/2019
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