Healthcare Provider Details

I. General information

NPI: 1649818550
Provider Name (Legal Business Name): REGINALD KEITH RIGGINS PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/11/2019
Last Update Date: 12/19/2025
Certification Date: 12/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4212 SAN FELIPE ST # 118
HOUSTON TX
77027-2902
US

IV. Provider business mailing address

4212 SAN FELIPE ST # 118
HOUSTON TX
77027-2902
US

V. Phone/Fax

Practice location:
  • Phone: 713-487-5744
  • Fax:
Mailing address:
  • Phone: 713-487-5574
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number38434
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: