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1053360214

NPI Code Detail

MEDICARE: REGINA P RIVERA MD

MEDICARE: REGINA P RIVERA MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207P00000X	Emergency Medicine Physician	2005002608	MO
2	207P00000X	Emergency Medicine Physician	M3713	TX

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	1H0243	OTHER	TX	MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	8V2874	OTHER	TX	BCBS
6	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
7	P00373324	OTHER	TX	RAILROAD

General Provider Information

NPI Number	:	1053360214
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	REGINA P RIVERA MD

Provider Business Mailing Address
First Line	:	3906 BOWSER AVE
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75219-3701
Country	:	US
Telephone Number	:	214-599-8729
Fax Number	:

Provider Business Practice Location Address
First Line	:	115 AIRPORT RD
Second Line	:
City	:	SULPHUR SPRINGS
State	:	TX
Zip	:	75482-2105
Country	:	US
Telephone Number	:	903-885-7671
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/08/2006
Last Update Date	:	01/11/2021

Similar Medicare Providers

1811848666 — CYNTHIA TAWAH
Practice Location Address:

115 AIRPORT RD
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75482-2105

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1396740387 — WILLIAM E DIETZE MD
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1043218548 — KEVIN W CATON CRNA
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1598757775 — HOPKINS COUNTY HOSPITAL DISTRICT
Practice Location Address:

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SULPHUR SPRINGS, TX
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Practice Phone: 903-885-7671
Practice Fax:

1184618548 — HOPKINS COUNTY HOSPITAL DISTRICT
Practice Location Address:

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75482-2105

Practice Phone: 903-885-7671
Practice Fax: 903-885-4579

1710973748 — DAVID WEIGAND SARGENT DO
Practice Location Address:

101 MEDICAL PLAZA
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Practice Phone: 903-885-6534
Practice Fax: 903-885-5109

Directions to “ REGINA P RIVERA MD” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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