Provider Demographics
NPI:1083234934
Name:MATOS, CHRISAYDEE (RN)
Entity Type:Individual
Prefix:MRS
First Name:CHRISAYDEE
Middle Name:
Last Name:MATOS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:CHRISAYDEE
Other - Middle Name:
Other - Last Name:NAVEDO SALAS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3332 SWITCHGRASS CIR APT 1201
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76177-1070
Mailing Address - Country:US
Mailing Address - Phone:787-632-0936
Mailing Address - Fax:
Practice Address - Street 1:3332 SWITCHGRASS CIR APT 1201
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76177-1070
Practice Address - Country:US
Practice Address - Phone:787-632-0936
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-21
Last Update Date:2020-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX964918163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse