Healthcare Provider Details

I. General information

NPI: 1831456433
Provider Name (Legal Business Name): JOSHUA JUDE RIVET M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/19/2012
Last Update Date: 01/23/2025
Certification Date: 01/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3327 COLORADO BLVD STE 100
DENTON TX
76210-6866
US

IV. Provider business mailing address

800 8TH AVE STE 206
FORT WORTH TX
76104-2619
US

V. Phone/Fax

Practice location:
  • Phone: 940-287-3793
  • Fax: 817-539-9310
Mailing address:
  • Phone: 817-529-9199
  • Fax: 817-539-9310

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License NumberS8105
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code2086S0122X
TaxonomyPlastic and Reconstructive Surgery Physician
License NumberS8105
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: