Organization
CLINICA NUEVO LEON, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MIGUEL A MATA FNP-C (FAMILY NURSE PRACTITIONER/PROVIDER)
(956) 778-4598
Entity
Organization
Contact information
Practice address
3601 TOM GILL RD, PENITAS, TX 78576-7352
(956) 778-4598
Mailing address
3601 TOM GILL RD, PENITAS, TX 78576-7352
(956) 778-4598
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
—
—
Other
Enumeration date
02/20/2020
Last updated
12/01/2020
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