Healthcare Provider Details

I. General information

NPI: 1003106287
Provider Name (Legal Business Name): MAYRIM V. RIOS PEREZ MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/09/2011
Last Update Date: 10/05/2023
Certification Date: 10/05/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

902 FROSTWOOD DR STE 265
HOUSTON TX
77024-2422
US

IV. Provider business mailing address

902 FROSTWOOD DR STE 265
HOUSTON TX
77024-2422
US

V. Phone/Fax

Practice location:
  • Phone: 713-785-5007
  • Fax: 713-785-8877
Mailing address:
  • Phone: 713-785-5007
  • Fax: 713-785-8877

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number021333
License Number StatePR
# 2
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberS6923
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: