MEDICARE: DR. FRANK J RIVERA 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
1	2085R0202X	Diagnostic Radiology Physician	G5541	TX
2	2085R0204X	Vascular & Interventional Radiology Physician	G5541	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	G5541	OTHER	TX	MEDICAL LICENSE

General Provider Information

NPI Number	:	1760437305
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. FRANK J RIVERA MD

Provider Business Mailing Address
First Line	:	1505 LBJ FWY STE 700
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75234-6065
Country	:	US
Telephone Number	:	214-358-2300
Fax Number	:	214-366-6127

Provider Business Practice Location Address
First Line	:	3604 LIVE OAK ST
Second Line	:	SUITE # 100
City	:	DALLAS
State	:	TX
Zip	:	75204-6168
Country	:	US
Telephone Number	:	214-358-2300
Fax Number	:	214-366-6330

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

Provider Enumeration Date	:	05/23/2006
Last Update Date	:	03/13/2024

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Directions to “ DR. FRANK J RIVERA MD” Practice Location

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