Provider Demographics
NPI:1417347659
Name:MATHES, ELIZABETH ANN (RN, FNP)
Entity Type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:ANN
Last Name:MATHES
Suffix:
Gender:F
Credentials:RN, FNP
Other - Prefix:MS
Other - First Name:ELIZABETH
Other - Middle Name:ANN
Other - Last Name:FLORES COLLIER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LVN, RN
Mailing Address - Street 1:325 E SONTERRA BLVD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78258-4054
Mailing Address - Country:US
Mailing Address - Phone:210-402-3069
Mailing Address - Fax:210-424-0631
Practice Address - Street 1:325 E SONTERRA BLVD
Practice Address - Street 2:SUITE 200
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78258-4054
Practice Address - Country:US
Practice Address - Phone:210-402-3069
Practice Address - Fax:210-424-0631
Is Sole Proprietor?:No
Enumeration Date:2015-01-26
Last Update Date:2015-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX645025363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily