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General NPI Number Information
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NPI Number | 1902330673
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Entity Type | Individual
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Provider Name | REBECCA RIVERA PA-C
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Gender | Female
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Dates
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Enumeration Date | 04/19/2017
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Last Update Date | 10/14/2024
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Provider Practice Location Address
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Address Line | 122 W CHAMPION ST
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City | EDINBURG
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State | TX
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Zip | 78539-4429
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Country | US
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Telephone | 956-287-1207
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Fax | 956-287-1292
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Provider Business Mailing Address
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Address Line | 800 BRADBURY DR SE STE 116
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City | ALBUQUERQUE
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State | NM
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Zip | 87106-4310
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Country | US
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Telephone | 505-272-1476
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Fax | 956-287-1292
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA2018-0028
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License Number State | NM
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