Healthcare Provider Details

I. General information

NPI: 1437632338
Provider Name (Legal Business Name): AIMEE MARIN RIVAS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/07/2018
Last Update Date: 12/15/2025
Certification Date: 12/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5401 LONG PRAIRIE RD
FLOWER MOUND TX
75028-2212
US

IV. Provider business mailing address

1512 TEASLEY LN
DENTON TX
76205-7282
US

V. Phone/Fax

Practice location:
  • Phone: 214-513-2300
  • Fax:
Mailing address:
  • Phone: 940-442-5209
  • Fax: 940-222-2720

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP145460
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberF343381
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: