Provider Demographics
NPI:1033276944
Name:RIOS, ROLANDO RENE (OD)
Entity Type:Individual
Prefix:DR
First Name:ROLANDO
Middle Name:RENE
Last Name:RIOS
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1506 E 6TH ST
Mailing Address - Street 2:
Mailing Address - City:WESLACO
Mailing Address - State:TX
Mailing Address - Zip Code:78596
Mailing Address - Country:US
Mailing Address - Phone:956-968-3307
Mailing Address - Fax:956-968-4403
Practice Address - Street 1:1506 E 6TH ST
Practice Address - Street 2:
Practice Address - City:WESLACO
Practice Address - State:TX
Practice Address - Zip Code:78596
Practice Address - Country:US
Practice Address - Phone:956-968-3307
Practice Address - Fax:956-968-4403
Is Sole Proprietor?:No
Enumeration Date:2007-01-02
Last Update Date:2020-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2753TG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX112431501Medicaid
P15562Medicare UPIN
TX0353ZMedicare ID - Type Unspecified