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NPI Code Detail

MEDICARE: DR. HUMBERTO RIVAS M.D.

MEDICARE: DR. HUMBERTO RIVAS M.D.
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
1208000000XPediatrics Physician208000000XTX

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
3110010OTHERTXMEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2J3202OTHERTXSTATE LI

General Provider Information

NPI Number : 1376547919
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. HUMBERTO RIVAS M.D.
Provider Business Mailing Address
First Line : 1110 N SARAH DEWITT DR
Second Line :
City : GONZALES
State : TX
Zip : 78629-3311
Country : US
Telephone Number : 830-672-8502
Fax Number :
Provider Business Practice Location Address
First Line : 1110 N SARAH DEWITT DR
Second Line :
City : GONZALES
State : TX
Zip : 78629-3311
Country : US
Telephone Number : 830-672-8473
Fax Number : 830-672-3035
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/10/2005
Last Update Date : 05/11/2026

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Directions to “ DR. HUMBERTO RIVAS M.D.” Practice Location

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