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General NPI Number Information
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NPI Number | 1265255897
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Entity Type | Individual
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Provider Name | ALICIA RIVAS CARRERA
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Gender | Female
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Dates
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Enumeration Date | 11/04/2024
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Last Update Date | 11/11/2024
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Provider Practice Location Address
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Address Line | 5003 ROYAL ARBOR LN
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City | HOUSTON
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State | TX
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Zip | 77084-3990
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Country | US
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Telephone | 361-929-6584
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Fax |
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Provider Business Mailing Address
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Address Line | 5003 ROYAL ARBOR LN
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City | HOUSTON
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State | TX
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Zip | 77084-3990
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Country | US
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Telephone | 361-929-6584
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207QA0505X
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Taxonomy Name | Adult Medicine Physician
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License Number | 1177106
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License Number State | TX
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