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General NPI Number Information
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NPI Number | 1659477701
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Entity Type | Organization
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Legal Business Name | ERJ MEDICAL P.A.
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Dates
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Enumeration Date | 09/16/2006
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Last Update Date | 10/07/2020
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Provider Practice Location Address
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Address Line | 1717 BROWN ST STE 3
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City | EL PASO
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State | TX
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Zip | 79902-4730
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Country | US
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Telephone | 915-261-7226
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 222187
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City | EL PASO
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State | TX
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Zip | 79913-5187
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Country | US
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Telephone | 915-219-4300
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Fax | 915-519-4300
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Authorized Official
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Title or Position | OWNER
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Name | EFRAIN RIVERA JR.
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Credential | M.D.
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Telephone | 915-219-4300
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208VP0014X
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Taxonomy Name | Interventional Pain Medicine Physician
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License Number | G1525
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License Number State | TX
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