Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | MD045906 | DC |
Y | 2080P0203X | Pediatric Critical Care Doctor | S7723 | TX |
NPI | 1134443690 |
---|---|
Provider Name | Sonia Isabel Matehuala |
First Address | San Antonio, TX 78229-3749 |
Second Address | San Antonio, TX 78229-3902 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 25/03/2010 |
Last Update Date | 09/09/2020 |