Provider Demographics
NPI:1679735013
Name:DR. ORLANDO H. RIVERA, DPM, P.A.
Entity Type:Organization
Organization Name:DR. ORLANDO H. RIVERA, DPM, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ORLANDO
Authorized Official - Middle Name:HERACLIO
Authorized Official - Last Name:RIVERA
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:713-691-9600
Mailing Address - Street 1:5225 KATY FWY STE 650
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77007-2255
Mailing Address - Country:US
Mailing Address - Phone:713-691-9600
Mailing Address - Fax:713-692-9663
Practice Address - Street 1:5225 KATY FWY STE 650
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77007-2255
Practice Address - Country:US
Practice Address - Phone:713-691-9600
Practice Address - Fax:713-692-9663
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-26
Last Update Date:2020-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1311213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX092853302Medicaid
TX480032577OtherRAILROAD MEDICARE NUMBER
TX1311OtherSTATE LICENSE NUMBER
TX4204540001Medicare NSC
TX1311OtherSTATE LICENSE NUMBER
TX480032577OtherRAILROAD MEDICARE NUMBER