Provider Demographics
NPI:1902413958
Name:RIVERA, CRISTIAN H (NP)
Entity Type:Individual
Prefix:
First Name:CRISTIAN
Middle Name:H
Last Name:RIVERA
Suffix:
Gender:M
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20323 STONEBRIDGE TERRACE CT
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:TX
Mailing Address - Zip Code:77407-4193
Mailing Address - Country:US
Mailing Address - Phone:832-671-4090
Mailing Address - Fax:
Practice Address - Street 1:427 W 20TH ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77008-2441
Practice Address - Country:US
Practice Address - Phone:713-838-2300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-24
Last Update Date:2021-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX900243163WM0705X
TX1029924363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
No163WM0705XNursing Service ProvidersRegistered NurseMedical-Surgical