Provider Demographics
NPI:1093030470
Name:RIVERA, JAVIER (MD)
Entity Type:Individual
Prefix:
First Name:JAVIER
Middle Name:
Last Name:RIVERA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7026 OLD KATY RD
Mailing Address - Street 2:SUITE 276
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77024-2133
Mailing Address - Country:US
Mailing Address - Phone:713-621-7436
Mailing Address - Fax:
Practice Address - Street 1:7026 OLD KATY RD
Practice Address - Street 2:SUITE 276
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77024-2133
Practice Address - Country:US
Practice Address - Phone:713-621-7436
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-03-29
Last Update Date:2016-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXQ32812085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology