Provider Demographics
NPI:1346770369
Name:RILEY, CATHERINE D (MD)
Entity Type:Individual
Prefix:
First Name:CATHERINE
Middle Name:D
Last Name:RILEY
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:4560 LAKE RIDGE PKWY STE 200
Mailing Address - Street 2:
Mailing Address - City:GRAND PRAIRIE
Mailing Address - State:TX
Mailing Address - Zip Code:75052-1706
Mailing Address - Country:US
Mailing Address - Phone:972-263-5272
Mailing Address - Fax:972-263-3488
Practice Address - Street 1:4560 LAKE RIDGE PKWY STE 200
Practice Address - Street 2:
Practice Address - City:GRAND PRAIRIE
Practice Address - State:TX
Practice Address - Zip Code:75052-1706
Practice Address - Country:US
Practice Address - Phone:972-263-5272
Practice Address - Fax:972-263-3488
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-13
Last Update Date:2021-11-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KS94-09278207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine