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NPI Code Detail

MEDICARE: RIO ORTHOPEDICS AND SPORTS MEDICINE, PLLC

MEDICARE: RIO ORTHOPEDICS AND SPORTS MEDICINE, PLLC
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
1207X00000XOrthopaedic Surgery Physician

General Provider Information

NPI Number : 1346869401
Entity Type Code : Organization
Provider Name (Legal Business Name) : RIO ORTHOPEDICS AND SPORTS MEDICINE, PLLC
Provider Business Mailing Address
First Line : 8210 MID CITIES BLVD
Second Line : SUITE 120
City : N RICHLND HLS
State : TX
Zip : 76180-4701
Country : US
Telephone Number : 817-969-6030
Fax Number : 817-969-6039
Provider Business Practice Location Address
First Line : 8210 MID CITIES BLVD
Second Line : SUITE 120
City : N RICHLND HLS
State : TX
Zip : 76180-4701
Country : US
Telephone Number : 817-969-6030
Fax Number : 817-969-6039
Authorized Official
Title or Position : OWNER
Name : NICHOLAS DOMINIC IAGULLI
Credential : MD
Telephone Number : 817-969-6030
Provider Enumeration Date : 04/09/2020
Last Update Date : 10/12/2020

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Directions to “RIO ORTHOPEDICS AND SPORTS MEDICINE, PLLC ” Practice Location

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