Provider Demographics
NPI:1457583585
Name:RIVERA REYES, HECTOR L (MD)
Entity Type:Individual
Prefix:
First Name:HECTOR
Middle Name:L
Last Name:RIVERA REYES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:HECTOR
Other - Middle Name:L
Other - Last Name:RIVERA REYES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:22 AVE LOS MAESTROS
Mailing Address - Street 2:
Mailing Address - City:MAYAGUEZ
Mailing Address - State:PR
Mailing Address - Zip Code:00682-5952
Mailing Address - Country:US
Mailing Address - Phone:939-267-5883
Mailing Address - Fax:
Practice Address - Street 1:22 AVE LOS MAESTROS
Practice Address - Street 2:
Practice Address - City:MAYAGUEZ
Practice Address - State:PR
Practice Address - Zip Code:00682
Practice Address - Country:US
Practice Address - Phone:939-267-5883
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-24
Last Update Date:2023-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR180302084P0800X, 2084P0804X
TXR75822084P0800X
OK405832084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRHT763AMedicare PIN