Individual
DR. DIEGO RIVERA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MDPA
Contact information
Practice address
111 N UNIVERSITY AVE, LUBBOCK, TX 79415-2844
(806) 747-4415
(806) 747-1304
Mailing address
111 N UNIVERSITY AVE, LUBBOCK, TX 79415-2844
(806) 747-4415
(806) 747-1304
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
G1757
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
123854505
—
TX
Enumeration date
12/05/2006
Last updated
12/14/2007
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