Individual provider · Type 1 NPI

Thelicia Mata, APRN-CNP

Acute Care Nurse Practitioner · San Antonio, TX

NPI number 1063391845 Active

Practice location

4502 Medical Dr
San Antonio, TX 78229-4402

Fax (210) 567-4659

Specialties and licenses

TaxonomyCodeLicense
Acute Care Nurse Practitioner Primary 363LA2100X1210733 (TX)
Gerontology Nurse Practitioner 363LG0600X1210733 (TX)
Nurse Practitioner 363L00000X1210733 (TX)

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About NPI 1063391845

Thelicia Mata, APRN-CNP's National Provider Identifier is 1063391845, issued on Aug 27, 2025. The primary taxonomy on file is Acute Care Nurse Practitioner (363LA2100X), and the practice location is in San Antonio, TX. The record was last updated on Nov 4, 2025.