Healthcare Provider Details

I. General information

NPI: 1649736331
Provider Name (Legal Business Name): JULIO RIOS JR FNP-C
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/18/2019
Last Update Date: 02/18/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5505 S EXPRESSWAY 77 STE 205
HARLINGEN TX
78550-3222
US

IV. Provider business mailing address

5505 S EXPRESSWAY 77 STE 205
HARLINGEN TX
78550-3222
US

V. Phone/Fax

Practice location:
  • Phone: 956-421-2757
  • Fax: 956-421-2787
Mailing address:
  • Phone: 956-421-2757
  • Fax: 956-421-2787

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAP140012
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: