Waverly Primary Care, Pllc
NPI #1215557715 in New Waverly, Texas
Provider Information
- NPI Number
- 1215557715
- Entity Type
- Organization
- Organization Name
- Waverly Primary Care, Pllc
- Primary Specialty
- Nurse Practitioner - Family
- Enumeration Date
- Apr 24, 2020
- Last Updated
- Apr 24, 2020
Practice Location
- Address
- 9329 STATE HWY 75
- City
- New Waverly
- State
- Texas
- ZIP Code
- 77358
- Phone
- (936) 284-2055
Authorized Official
- Name
- KRISTINA MATA, FNP-C
- Title
- OWNER, AUTHORIZED OFFICIAL
- Phone
- (936) 284-2055
Specialties & Taxonomy Codes
| Specialty |
|---|
| Nurse Practitioner - Family — Family |
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