Provider Demographics
NPI:1396835526
Name:GARCIA-RILEY, MARIBEL (OD)
Entity Type:Individual
Prefix:DR
First Name:MARIBEL
Middle Name:
Last Name:GARCIA-RILEY
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1955 BABCOCK RD
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78229-4511
Mailing Address - Country:US
Mailing Address - Phone:210-530-2733
Mailing Address - Fax:210-530-2735
Practice Address - Street 1:1955 BABCOCK RD
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-4511
Practice Address - Country:US
Practice Address - Phone:210-530-2733
Practice Address - Fax:210-530-2735
Is Sole Proprietor?:No
Enumeration Date:2006-10-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX4972T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX4972TOtherLICENSE
TX00840EMedicare ID - Type Unspecified
TXU53818Medicare UPIN