Healthcare Provider Details

I. General information

NPI: 1801077631
Provider Name (Legal Business Name): RIVERS MULTI PLEX MEDICAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/20/2007
Last Update Date: 11/20/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9896 BISSONNET ST SUITE 250
HOUSTON TX
77036-8104
US

IV. Provider business mailing address

10203 FINCHWOOD LN
HOUSTON TX
77036-8606
US

V. Phone/Fax

Practice location:
  • Phone: 713-773-3443
  • Fax: 713-773-3565
Mailing address:
  • Phone: 832-477-1073
  • Fax: 713-773-3565

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code302F00000X
TaxonomyExclusive Provider Organization
License Number
License Number State

VIII. Authorized Official

Name: DR. LINDA IVORY JOHNSON
Title or Position: ADMINISTRATOR
Credential: ED.D
Phone: 832-477-1073