Rivera Mht LLC
Family Medicine in Lubbock, TX. Organization (NPI-2).
NPI number1972991990
StatusActive
Last updated in NPPESJan 6, 2015
Details
- NPI
- 1972991990
- Entity type
- Organization (NPI-2)
- Legal business name
- Rivera Mht LLC
- Organization subpart
- No
- Enumeration date
- Dec 29, 2014
- Last updated
- Jan 6, 2015
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207Q00000X | Family Medicine | G1757 | TX | Yes |
Practice location
111 N University AveLubbock, TX 79415-2844
Phone 806-747-4415
Mailing address
1515 Heritage Dr Ste 110McKinney, TX 75069-3379
Authorized official
Diego Rivera
Owner / President
8067474415
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