Provider Demographics
NPI:1548557861
Name:RIVERS, PAULA (MS)
Entity Type:Individual
Prefix:
First Name:PAULA
Middle Name:
Last Name:RIVERS
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2003 S LAMAR BLVD STE 4
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78704-4103
Mailing Address - Country:US
Mailing Address - Phone:512-704-7447
Mailing Address - Fax:512-519-4385
Practice Address - Street 1:2003 S LAMAR BLVD STE 4
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78704-4103
Practice Address - Country:US
Practice Address - Phone:512-704-7447
Practice Address - Fax:512-519-4385
Is Sole Proprietor?:No
Enumeration Date:2011-07-07
Last Update Date:2016-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX80248231H00000X, 237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter
No231H00000XSpeech, Language and Hearing Service ProvidersAudiologist