Provider Demographics
NPI:1700179645
Name:MATEO, CHRISTINA CARMEN (MD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTINA
Middle Name:CARMEN
Last Name:MATEO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:CHRISTINA CARMEN
Other - Middle Name:DIRECTO
Other - Last Name:MATEO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:5021 CROSSROADS DR
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79932-1635
Mailing Address - Country:US
Mailing Address - Phone:915-790-5700
Mailing Address - Fax:
Practice Address - Street 1:5021 CROSSROADS DR
Practice Address - Street 2:UNIVERSITY MEDICAL CENTER CROSSROADS
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79932-1635
Practice Address - Country:US
Practice Address - Phone:915-521-7050
Practice Address - Fax:915-584-2851
Is Sole Proprietor?:No
Enumeration Date:2011-05-25
Last Update Date:2016-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXP9683208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics