Healthcare Provider Details

I. General information

NPI: 1861879447
Provider Name (Legal Business Name): LAURA ALICIA RIVERA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/02/2015
Last Update Date: 09/23/2026
Certification Date: 09/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4217 NORTH MCCOLL RD STE 700
MCALLEN TX
78504-4466
US

IV. Provider business mailing address

4217 N MCCOLL RD STE 700
MCALLEN TX
78504-1100
US

V. Phone/Fax

Practice location:
  • Phone: 956-627-0817
  • Fax: 956-627-0975
Mailing address:
  • Phone: 956-627-0817
  • Fax: 956-627-0975

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207VX0000X
TaxonomyObstetrics Physician
License NumberS1398
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: