MEDICARE: DR. JAIME J RIVERA DC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	5999DC	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1225100431
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JAIME J RIVERA DC

Provider Business Mailing Address
First Line	:	814 E HARRISON AVE
Second Line	:
City	:	HARLINGEN
State	:	TX
Zip	:	78550-7120
Country	:	US
Telephone Number	:	956-412-8551
Fax Number	:	956-412-0573

Provider Business Practice Location Address
First Line	:	814 E HARRISON AVE
Second Line	:
City	:	HARLINGEN
State	:	TX
Zip	:	78550-7120
Country	:	US
Telephone Number	:	956-412-8551
Fax Number	:	956-412-0573

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/14/2006
Last Update Date	:	06/21/2023

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