Provider Demographics
NPI:1104239425
Name:RIOJAS, LARISSA NYVIA (DO)
Entity type:Individual
Prefix:
First Name:LARISSA
Middle Name:NYVIA
Last Name:RIOJAS
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1206 E 6TH ST
Mailing Address - Street 2:
Mailing Address - City:WESLACO
Mailing Address - State:TX
Mailing Address - Zip Code:78596-6420
Mailing Address - Country:US
Mailing Address - Phone:956-447-8377
Mailing Address - Fax:956-973-8034
Practice Address - Street 1:1206 E 6TH ST
Practice Address - Street 2:
Practice Address - City:WESLACO
Practice Address - State:TX
Practice Address - Zip Code:78596-6420
Practice Address - Country:US
Practice Address - Phone:956-447-8377
Practice Address - Fax:956-973-8034
Is Sole Proprietor?:No
Enumeration Date:2014-06-04
Last Update Date:2020-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXR3411207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine