MEDICARE: TERRI HENRY RIVAS

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	3747A0650X	Attendant Care Provider
2	385H00000X	Respite Care
3	3747P1801X	Personal Care Attendant

General Provider Information

NPI Number	:	1215424155
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TERRI HENRY RIVAS

Provider Business Mailing Address
First Line	:	PO BOX 12028
Second Line	:
City	:	SPRING
State	:	TX
Zip	:	77391-2028
Country	:	US
Telephone Number	:	832-264-2335
Fax Number	:

Provider Business Practice Location Address
First Line	:	20911 CORAL BRIDGE LN
Second Line	:
City	:	SPRING
State	:	TX
Zip	:	77388-5318
Country	:	US
Telephone Number	:	832-264-2335
Fax Number	:

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

Provider Enumeration Date	:	04/17/2018
Last Update Date	:	04/17/2018

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Directions to “ TERRI HENRY RIVAS ” Practice Location

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