Provider Demographics
NPI:1740426261
Name:ANGELINA A. RIVERO, M.D., P.A.
Entity Type:Organization
Organization Name:ANGELINA A. RIVERO, M.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ANGELINA
Authorized Official - Middle Name:A
Authorized Official - Last Name:RIVERO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:972-932-3388
Mailing Address - Street 1:874 ED HALL DR
Mailing Address - Street 2:SUITE 115
Mailing Address - City:KAUFMAN
Mailing Address - State:TX
Mailing Address - Zip Code:75142-1861
Mailing Address - Country:US
Mailing Address - Phone:972-932-3388
Mailing Address - Fax:
Practice Address - Street 1:874 ED HALL DR
Practice Address - Street 2:SUITE 115
Practice Address - City:KAUFMAN
Practice Address - State:TX
Practice Address - Zip Code:75142-1861
Practice Address - Country:US
Practice Address - Phone:972-932-3388
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-06
Last Update Date:2011-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF5014174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
DB9800OtherRAILROAD PTAN
0A4700Medicare PIN