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Individual

DR. LUIS MANUEL RIOS JR.

Active
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Individual

DR. LUIS MANUEL RIOS JR.

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Taxonomy

Speciality
Code
Description
License number
State
2086S0122X
Plastic and Reconstructive Surgery Physician
Primary
J0221
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0059GS
BLUE CROSS/BLUE SHIELD GROUP
TX
05
031479101
TX
05
152179101
TX
01
742883624
WORKERS COMP #
TX
01
742883624
FEDERAL TAX ID#
01
8B6021
BLUE CROSS PROVIDER #
TX
Enumeration date
08/19/2005
Last updated
11/09/2011
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