MEDICARE: SUNRISE HEALTH CLINIC

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	207R00000X	Internal Medicine Physician	L2602	TX

General Provider Information

NPI Number	:	1871866814
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SUNRISE HEALTH CLINIC

Provider Business Mailing Address
First Line	:	4615 NORTH FWY
Second Line	:	122
City	:	HOUSTON
State	:	TX
Zip	:	77022-2917
Country	:	US
Telephone Number	:	713-695-0500
Fax Number	:

Provider Business Practice Location Address
First Line	:	4615 NORTH FWY
Second Line	:	122
City	:	HOUSTON
State	:	TX
Zip	:	77022-2917
Country	:	US
Telephone Number	:	713-695-0500
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. NORMA RIVERA-OPIO
Credential	:	M.D.
Telephone Number	:	71369505000

Provider Enumeration Date	:	02/22/2012
Last Update Date	:	02/22/2012

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Directions to “SUNRISE HEALTH CLINIC ” Practice Location

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