Provider Demographics
NPI:1629386990
Name:PABLO R. RIVERA, M.D., P.A.
Entity Type:Organization
Organization Name:PABLO R. RIVERA, M.D., P.A.
Other - Org Name:MID-VALLEY WOMEN'S HEALTH AND SURGICAL ARTS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PABLO
Authorized Official - Middle Name:RENE
Authorized Official - Last Name:RIVERA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:956-969-8369
Mailing Address - Street 1:702 E EXPRESSWAY 83
Mailing Address - Street 2:SUITE A-5
Mailing Address - City:DONNA
Mailing Address - State:TX
Mailing Address - Zip Code:78537-2741
Mailing Address - Country:US
Mailing Address - Phone:956-969-8369
Mailing Address - Fax:
Practice Address - Street 1:702 E EXPRESSWAY 83
Practice Address - Street 2:SUITE A-5
Practice Address - City:DONNA
Practice Address - State:TX
Practice Address - Zip Code:78537-2741
Practice Address - Country:US
Practice Address - Phone:956-969-8369
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-20
Last Update Date:2010-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN5362261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty