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General NPI Number Information
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NPI Number | 1588612634
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Entity Type | Individual
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Provider Name | HOMERO RIVAS MD
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Gender | Male
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Dates
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Enumeration Date | 05/04/2006
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Last Update Date | 01/28/2016
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Provider Practice Location Address
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Address Line | 5323 HARRY HINES BLVD
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City | DALLAS
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State | TX
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Zip | 75390-7208
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Country | US
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Telephone | 214-645-2900
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Fax |
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Provider Business Mailing Address
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Address Line | 300 PASTEUR DR H3680
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City | STANFORD
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State | CA
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Zip | 94305-2200
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Country | US
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Telephone | 650-721-2757
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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 | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | M1321
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | C53953
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License Number State | CA
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