Mata, Israel
Mata, Israel is an sole proprietor health care provider with primary practice located at 105 E Polk Ave , Pharr TX 78577-3110. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as his primary health care specialty. Mata, Israel can be contacted via phone (956) 781-6591.Contact Information
Primary practice address
105 E Polk Ave
Pharr TX 78577-3110
Phone: (956) 781-6591
Fax: (956) 702-0185
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | J2456 | Texas |
Profile Details
| NPI number | 1881693018 |
|---|---|
| LBN Legal business name | Mata, Israel |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jul 19th, 2005 |
| Last updated | May 14th, 2017 - about 9 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1881693018 | NPPES |
| Texas | MEDICAID | 121107003 | |
| Texas | MEDICAID | 121107006 | |
| Texas | MEDICAID | 121107001 |
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