Provider Demographics
NPI:1508315755
Name:PADILLA RIOS, OSCAR (CNIM 3338)
Entity Type:Individual
Prefix:
First Name:OSCAR
Middle Name:
Last Name:PADILLA RIOS
Suffix:
Gender:M
Credentials:CNIM 3338
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1356 OLD CREEK DR
Mailing Address - Street 2:
Mailing Address - City:TYLER
Mailing Address - State:TX
Mailing Address - Zip Code:75703-7642
Mailing Address - Country:US
Mailing Address - Phone:903-534-0809
Mailing Address - Fax:903-939-9149
Practice Address - Street 1:1356 OLD CREEK DR
Practice Address - Street 2:
Practice Address - City:TYLER
Practice Address - State:TX
Practice Address - Zip Code:75703-7642
Practice Address - Country:US
Practice Address - Phone:903-534-0809
Practice Address - Fax:903-939-9149
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-29
Last Update Date:2019-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX3338246ZE0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZE0600XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherElectroneurodiagnostic