Provider Demographics
NPI:1942302856
Name:MATOS, REBEKAH RACHEL (FNP)
Entity Type:Individual
Prefix:
First Name:REBEKAH
Middle Name:RACHEL
Last Name:MATOS
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:REBEKAH
Other - Middle Name:RACHEL
Other - Last Name:KLARBERG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4114 POND HILL RD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78231-1272
Mailing Address - Country:US
Mailing Address - Phone:210-249-5020
Mailing Address - Fax:210-572-1540
Practice Address - Street 1:902 FROSTWOOD DR
Practice Address - Street 2:SUITE 210
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77024-2420
Practice Address - Country:US
Practice Address - Phone:713-464-4107
Practice Address - Fax:713-465-4522
Is Sole Proprietor?:No
Enumeration Date:2006-09-01
Last Update Date:2023-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI2917363L00000X, 363LF0000X
TXAP124368363L00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
363LF0000XOtherTAXONOMY
363LF0000XOtherTAXONOMY