Provider Demographics
NPI:1598746331
Name:RIOS, GADDIEL DAVID (MD)
Entity Type:Individual
Prefix:DR
First Name:GADDIEL
Middle Name:DAVID
Last Name:RIOS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:105 N STATE ROAD 14
Mailing Address - Street 2:PO BOX 219
Mailing Address - City:AKRON
Mailing Address - State:IN
Mailing Address - Zip Code:46910-9121
Mailing Address - Country:US
Mailing Address - Phone:574-598-2020
Mailing Address - Fax:574-223-5847
Practice Address - Street 1:2222 GREENHOUSE RD STE 1000
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77084-7342
Practice Address - Country:US
Practice Address - Phone:281-944-9095
Practice Address - Fax:888-809-8549
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-09
Last Update Date:2019-05-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXM2460207Q00000X
IN01051979A207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXM2460OtherMEDICAL LICENSE