Walter Ivan Rivera, MD
Student in an Organized Health Care Education/Training Program in Odessa, TX. Individual provider (NPI-1).
NPI number1164089215
StatusActive
Last updated in NPPESMar 30, 2024
Details
- NPI
- 1164089215
- Entity type
- Individual (NPI-1)
- Name
- Walter Ivan Rivera
- Credential
- MD
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- May 23, 2019
- Certification date
- Mar 30, 2024
- Last updated
- Mar 30, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 390200000X | Student in an Organized Health Care Education/Training Program | – | – | Yes |
| 246ZC0007X | Specialist/Technologist, Other, Surgical Assistant | 19-259 | WI |
Practice location
701 W 5th StOdessa, TX 79763-4206
Phone 432-703-5238
Mailing address
701 W 5th StOdessa, TX 79763-4206
Phone 432-703-5238
Other practice locations
1309 E Ridge Rd Ste 1
McAllen, TX 78503-1518
McAllen, TX 78503-1518
Phone 956-631-8875 · Fax 956-682-6280
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