Provider Demographics
NPI:1326013186
Name:RIVI MEDICAL, PA
Entity Type:Organization
Organization Name:RIVI MEDICAL, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SADY
Authorized Official - Middle Name:MANOEL
Authorized Official - Last Name:RIBEIRO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:713-252-2664
Mailing Address - Street 1:8181 FANNIN ST
Mailing Address - Street 2:137
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77054-2911
Mailing Address - Country:US
Mailing Address - Phone:713-252-2664
Mailing Address - Fax:713-529-3667
Practice Address - Street 1:8181 FANNIN ST
Practice Address - Street 2:137
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77054-2911
Practice Address - Country:US
Practice Address - Phone:713-252-2664
Practice Address - Fax:713-529-3667
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ4668207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXF69423Medicare UPIN
TX0032WMedicare ID - Type UnspecifiedGROUP