Provider Demographics
NPI:1295263861
Name:RIVAS, RENEE NICOLE (MD, PHD)
Entity type:Individual
Prefix:DR
First Name:RENEE
Middle Name:NICOLE
Last Name:RIVAS
Suffix:
Gender:
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 4346, DEPT 5041
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77210
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:16415 ADDISON RD STE 900
Practice Address - Street 2:
Practice Address - City:ADDISON
Practice Address - State:TX
Practice Address - Zip Code:75001-3268
Practice Address - Country:US
Practice Address - Phone:214-319-8066
Practice Address - Fax:214-414-0376
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-26
Last Update Date:2025-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXV3421207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology