MEDICARE: VALERY Y RIOS

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	390200000X	Student in an Organized Health Care Education/Training Program

General Provider Information

NPI Number	:	1295493740
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VALERY Y RIOS

Provider Business Mailing Address
First Line	:	2124 BURTON DR APT 202
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78741-4171
Country	:	US
Telephone Number	:	512-961-9315
Fax Number	:

Provider Business Practice Location Address
First Line	:	2124 BURTON DR APT 202
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78741-4171
Country	:	US
Telephone Number	:	512-961-9315
Fax Number	:

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

Provider Enumeration Date	:	12/01/2021
Last Update Date	:	12/01/2021

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Directions to “ VALERY Y RIOS ” Practice Location

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