Individual
KRISTINE DEMATTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
300 UNIVERSITY BLVD, ROUND ROCK, TX 78665-1032
(512) 509-0100
Mailing address
PO BOX 844658, DALLAS, TX 75284-4658
(254) 724-8800
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
57.024423
OH
207R00000X
Internal Medicine Physician
R2081
TX
208M00000X
Hospitalist Physician
Primary
R2081
TX
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/03/2014
Last updated
01/11/2021
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