MEDICARE: RIVI MEDICAL, PA

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	207LP2900X	Pain Medicine (Anesthesiology) Physician	J4668	TX

General Provider Information

NPI Number	:	1326013186
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RIVI MEDICAL, PA

Provider Business Mailing Address
First Line	:	8181 FANNIN ST
Second Line	:	137
City	:	HOUSTON
State	:	TX
Zip	:	77054-2911
Country	:	US
Telephone Number	:	713-252-2664
Fax Number	:	713-529-3667

Provider Business Practice Location Address
First Line	:	8181 FANNIN ST
Second Line	:	137
City	:	HOUSTON
State	:	TX
Zip	:	77054-2911
Country	:	US
Telephone Number	:	713-252-2664
Fax Number	:	713-529-3667

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. SADY MANOEL RIBEIRO
Credential	:	MD
Telephone Number	:	713-252-2664

Provider Enumeration Date	:	02/22/2006
Last Update Date	:	08/22/2020

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