Individual
GLORIMAR MEDINA-RIVERA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
6411 FANNIN ST, HOUSTON, TX 77030-1501
(713) 500-6200
(713) 500-6201
Mailing address
PO BOX 301173, DALLAS, TX 75303-1173
(713) 500-3500
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
M5372
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
185858101
—
TX
01
—
185858102
CSHCN
TX
01
—
8AG240
BCBS
TX
01
—
8BC111
BCBS
TX
Enumeration date
05/14/2007
Last updated
08/15/2016
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