Healthcare Provider Details

I. General information

NPI: 1275440091
Provider Name (Legal Business Name): GRACIELA RIOS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/26/2026
Last Update Date: 08/26/2026
Certification Date: 08/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2040 NORTH LOOP W STE 300
HOUSTON TX
77018-8140
US

IV. Provider business mailing address

20018 LIONS GATE DR
HUMBLE TX
77338-1961
US

V. Phone/Fax

Practice location:
  • Phone: 713-750-9197
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number1245103
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: