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1619647393
LORRAINE MICHELLE MATA
EL PASO, TX
NPI
1619647393
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363LP0200X Nurse Practitioner, Pediatrics
(Licence: TX 1039612)
Enumeration Date
2021-09-15
Last Update Date
2021-09-15
Business Address
Mrs. LORRAINE MICHELLE MATA
1400 N EL PASO ST
EL PASO, TX 79902-3437
Phone number: 915-577-0445
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Mailing Address
Mrs. LORRAINE MICHELLE MATA
1400 N EL PASO ST STE E
EL PASO, TX 79902-3438
Phone number: 915-577-0445
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