Provider Demographics
NPI:1417044017
Name:RIVERWALK OB/GYN PLLC
Entity Type:Organization
Organization Name:RIVERWALK OB/GYN PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS OFFICE SUPERVISOR
Authorized Official - Prefix:MS
Authorized Official - First Name:SYLVIA
Authorized Official - Middle Name:
Authorized Official - Last Name:ARECHIGA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:210-226-5420
Mailing Address - Street 1:414 NAVARRO ST
Mailing Address - Street 2:SUITE 1200
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78205-2516
Mailing Address - Country:US
Mailing Address - Phone:210-226-5420
Mailing Address - Fax:210-222-9443
Practice Address - Street 1:414 NAVARRO ST
Practice Address - Street 2:SUITE 1200
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78205-2516
Practice Address - Country:US
Practice Address - Phone:210-226-5420
Practice Address - Fax:210-222-9443
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-06
Last Update Date:2008-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX083643901Medicaid
TXOOL13LMedicare Oscar/Certification