Individual
ANTONIO MATA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1055 CRYSTAL LAKE DR, FRISCO, TX 75036-8878
(305) 297-0334
Mailing address
701 S CARROLL BLVD STE 212, DENTON, TX 76201-6859
(305) 297-0334
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
019526
TX
Other
Enumeration date
06/12/2019
Last updated
05/21/2025
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