Provider Demographics
NPI:1215228267
Name:RIVERA-PADILLA, MABEL (MD)
Entity Type:Individual
Prefix:
First Name:MABEL
Middle Name:
Last Name:RIVERA-PADILLA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 WILSON DR
Mailing Address - Street 2:
Mailing Address - City:FLORESVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78114-2858
Mailing Address - Country:US
Mailing Address - Phone:830-393-3492
Mailing Address - Fax:830-393-3424
Practice Address - Street 1:100 WILSON DR
Practice Address - Street 2:
Practice Address - City:FLORESVILLE
Practice Address - State:TX
Practice Address - Zip Code:78114-2858
Practice Address - Country:US
Practice Address - Phone:830-393-3492
Practice Address - Fax:830-393-3424
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-26
Last Update Date:2019-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME 125707207Q00000X
PR18161207Q00000X
TXQ9894207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine