Individual
CHENGETAI BEVERLY MATENGENZARA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
18950 MARSH LN APT 208, DALLAS, TX 75287-2157
(214) 659-1138
Mailing address
18950 MARSH LN APT 208, DALLAS, TX 75287-2157
(214) 659-1138
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Enumeration date
03/20/2019
Last updated
02/10/2021
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