Provider Demographics
NPI:1508403494
Name:RIVERA, SYLVIA (LVN)
Entity Type:Individual
Prefix:
First Name:SYLVIA
Middle Name:
Last Name:RIVERA
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:513 VIENDO
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78201-4341
Mailing Address - Country:US
Mailing Address - Phone:210-414-7044
Mailing Address - Fax:
Practice Address - Street 1:513 VIENDO
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78201-4341
Practice Address - Country:US
Practice Address - Phone:210-414-7044
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-12-10
Last Update Date:2019-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX084211164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes164X00000XNursing Service ProvidersLicensed Vocational NurseGroup - Single Specialty