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General NPI Number Information
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NPI Number | 1336369842
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Entity Type | Organization
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Legal Business Name | MATA PHYSICAL THERAPY CLINIC
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Dates
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Enumeration Date | 04/26/2007
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Last Update Date | 10/03/2008
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Provider Practice Location Address
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Address Line | 5210 N 10TH ST
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City | MCALLEN
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State | TX
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Zip | 78504-2701
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Country | US
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Telephone | 956-686-4646
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 720267
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City | MCALLEN
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State | TX
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Zip | 78504-0267
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Country | US
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Telephone | 956-686-4646
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Fax |
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MRS. RUTH C MATA
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Credential |
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Telephone | 956-686-4646
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number | 1023703
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License Number State | TX
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