Individual
DAVID GUADALUPE MATA JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ANP
Contact information
Practice address
18707 HARDY OAK BLVD STE 530, SAN ANTONIO, TX 78258-4791
(210) 495-8280
(210) 481-3116
Mailing address
7913 BANDERA RD, SAN ANTONIO, TX 78250-6511
(210) 698-9841
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
619179
TX
Other
Enumeration date
04/19/2013
Last updated
09/02/2021
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