Healthcare Provider Details

I. General information

NPI: 1427686633
Provider Name (Legal Business Name): PAMELA CRISTINA DE LA CRUZ RIVERA MD/PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: PAMELA C DE LA CRUZ-RIVERA MD/PHD

II. Dates (important events)

Enumeration Date: 04/01/2020
Last Update Date: 12/23/2024
Certification Date: 12/23/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5323 HARRY HINES BLVD
DALLAS TX
75390-7201
US

IV. Provider business mailing address

5939 HARRY HINES BLVD STE 300
DALLAS TX
75235-6262
US

V. Phone/Fax

Practice location:
  • Phone: 214-648-2986
  • Fax: 214-648-4566
Mailing address:
  • Phone: 214-645-3838
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberU8042
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: