Provider Demographics
NPI:1700803467
Name:DR RIVERA & ASSOCIATES, P.A.
Entity Type:Organization
Organization Name:DR RIVERA & ASSOCIATES, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:INTERNAL MEDICINE
Authorized Official - Prefix:DR
Authorized Official - First Name:RAUL
Authorized Official - Middle Name:A
Authorized Official - Last Name:RIVERA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:713-944-4042
Mailing Address - Street 1:3808 WOODLAWN
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:TX
Mailing Address - Zip Code:77504-1933
Mailing Address - Country:US
Mailing Address - Phone:713-944-4042
Mailing Address - Fax:
Practice Address - Street 1:3808 WOODLAWN
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:TX
Practice Address - Zip Code:77504-1933
Practice Address - Country:US
Practice Address - Phone:713-944-4042
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-17
Last Update Date:2013-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX123992304Medicaid
TX291972201Medicaid
TX123992306Medicaid
TXF84077Medicare UPIN
TX00U19DMedicare PIN
TX123992306Medicaid