Provider Demographics
NPI:1013974443
Name:RIOJAS, DALILA VITE (MD)
Entity Type:Individual
Prefix:
First Name:DALILA
Middle Name:VITE
Last Name:RIOJAS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4201 INTERWAY PLACE
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76018
Mailing Address - Country:US
Mailing Address - Phone:817-652-9192
Mailing Address - Fax:817-652-3011
Practice Address - Street 1:4201 INTERWAY PLACE
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76018
Practice Address - Country:US
Practice Address - Phone:817-652-9192
Practice Address - Fax:817-652-3011
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-28
Last Update Date:2012-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ7641208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX111651901Medicaid
TX111651901Medicaid