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NPI Code Detail

MEDICARE: DR. DAVID M RILEY MD

MEDICARE: DR. DAVID M RILEY MD
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
12080N0001XNeonatal-Perinatal Medicine PhysicianL5534TX

General Provider Information

NPI Number : 1356342679
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. DAVID M RILEY MD
Provider Business Mailing Address
First Line : 801 7TH AVE
Second Line :
City : FORT WORTH
State : TX
Zip : 76104-2733
Country : US
Telephone Number : 682-885-4283
Fax Number :
Provider Business Practice Location Address
First Line : 801 7TH AVE
Second Line :
City : FORT WORTH
State : TX
Zip : 76104-2733
Country : US
Telephone Number : 682-885-4832
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/09/2005
Last Update Date : 12/16/2025

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