Provider Demographics
NPI:1942378799
Name:RIOS, ADAN A (MD)
Entity Type:Individual
Prefix:
First Name:ADAN
Middle Name:A
Last Name:RIOS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6431 FANNIN UT MEDICAL SCHOOL
Mailing Address - Street 2:MSB 5.282
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030
Mailing Address - Country:US
Mailing Address - Phone:832-325-6520
Mailing Address - Fax:713-512-7140
Practice Address - Street 1:6410 FANNIN UT ONCOLOGY
Practice Address - Street 2:SUITE 722
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030
Practice Address - Country:US
Practice Address - Phone:832-325-6520
Practice Address - Fax:713-512-7143
Is Sole Proprietor?:No
Enumeration Date:2006-12-01
Last Update Date:2009-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXE8850207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX122464405Medicaid
TXE8850OtherSTATE LISCENSE
TX82810XOtherBCBS
TX8J1935OtherMCBCBS
TX081110101Medicaid
TX00759KMedicare ID - Type Unspecified
TX8L4171Medicare PIN