Provider Demographics
NPI:1821679721
Name:RIVERON LEYVA, ANGEL (MD)
Entity type:Individual
Prefix:
First Name:ANGEL
Middle Name:
Last Name:RIVERON LEYVA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8471 GULF FWY
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77017-5001
Mailing Address - Country:US
Mailing Address - Phone:832-709-2770
Mailing Address - Fax:832-924-0113
Practice Address - Street 1:8471 GULF FWY
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77017-5001
Practice Address - Country:US
Practice Address - Phone:832-709-2770
Practice Address - Fax:832-924-0113
Is Sole Proprietor?:No
Enumeration Date:2021-04-21
Last Update Date:2024-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXV0520207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine