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General NPI Number Information
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NPI Number | 1689157208
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Entity Type | Organization
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Legal Business Name | UMATTER
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Dates
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Enumeration Date | 09/10/2018
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Last Update Date | 02/16/2023
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Provider Practice Location Address
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Address Line | 2039 E PRICE RD STE D10
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City | BROWNSVILLE
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State | TX
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Zip | 78521-2499
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Country | US
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Telephone | 833-628-8378
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Fax |
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Provider Business Mailing Address
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Address Line | 354 CARNAHAN ST
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City | SAN ANTONIO
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State | TX
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Zip | 78209-6325
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Country | US
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Telephone | 210-882-7096
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MRS. ROSANNA SHELTON
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Credential |
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Telephone | 210-882-7096
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 174H00000X
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Taxonomy Name | Health Educator
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License Number |
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License Number State |
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