Healthcare Provider Details

I. General information

NPI: 1619171295
Provider Name (Legal Business Name): JAVIER ANTONIO RIOS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/14/2007
Last Update Date: 05/05/2026
Certification Date: 05/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

905 W MEDICAL CENTER BLVD STE 201
WEBSTER TX
77598-4009
US

IV. Provider business mailing address

PO BOX 58538
WEBSTER TX
77598-8538
US

V. Phone/Fax

Practice location:
  • Phone: 281-985-9342
  • Fax:
Mailing address:
  • Phone: 281-332-2286
  • Fax: 281-336-1549

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QS0010X
TaxonomySports Medicine (Family Medicine) Physician
License NumberM8284
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: