Provider Demographics
NPI:1952617375
Name:RIOS, GUADALUPE RODRIGUEZ (FNP-BC)
Entity Type:Individual
Prefix:MS
First Name:GUADALUPE
Middle Name:RODRIGUEZ
Last Name:RIOS
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:310 W OAKLAWN RD
Mailing Address - Street 2:
Mailing Address - City:PLEASANTON
Mailing Address - State:TX
Mailing Address - Zip Code:78064-4033
Mailing Address - Country:US
Mailing Address - Phone:830-569-8940
Mailing Address - Fax:830-569-8320
Practice Address - Street 1:19010 PREIST BLVD
Practice Address - Street 2:
Practice Address - City:LYTLE
Practice Address - State:TX
Practice Address - Zip Code:78052-3486
Practice Address - Country:US
Practice Address - Phone:830-772-9865
Practice Address - Fax:830-772-9821
Is Sole Proprietor?:No
Enumeration Date:2010-08-23
Last Update Date:2020-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP119313363L00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX385126YKQQMedicare PIN