Healthcare Provider Details
I. General information
NPI: 1235929977
Provider Name (Legal Business Name): REGINALD RIGGINS II MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 05/07/2025
Last Update Date: 05/07/2025
Certification Date: 05/06/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
500 W MEDICAL CENTER BLVD
WEBSTER TX
77598-4220
US
IV. Provider business mailing address
11687 GLOWING SUNSET LN
LAS VEGAS NV
89135-1659
US
V. Phone/Fax
- Phone: 281-332-2511
- Fax:
- Phone: 702-553-6280
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 390200000X |
| Taxonomy | Student in an Organized Health Care Education/Training Program |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: