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NPI Code Detail

MEDICARE: JAZMINE JOYCE RIVERA

MEDICARE:   JAZMINE JOYCE RIVERA
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
1164X00000XLicensed Vocational Nurse342291TX

General Provider Information

NPI Number : 1295222917
Entity Type Code : Individual
Provider Name (Legal Business Name) : JAZMINE JOYCE RIVERA
Provider Business Mailing Address
First Line : 601 OAK HARBOR DR
Second Line :
City : HOUSTON
State : TX
Zip : 77062-2532
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 601 OAK HARBOR DR
Second Line :
City : HOUSTON
State : TX
Zip : 77062-2532
Country : US
Telephone Number : 832-630-4813
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/18/2018
Last Update Date : 04/18/2018

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Directions to “ JAZMINE JOYCE RIVERA ” Practice Location

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