Individual
EDGARDO RIVERA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M. D.
Taxonomy
Speciality
Code
Description
License number
State
207RX0202X
Medical Oncology Physician
Primary
44221
AZ
207RX0202X
Medical Oncology Physician
J1479
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
041341102
—
TX
01
—
8W1057
BLUE CROSS BLUE SHIELD
TX
01
—
P00442974
RAILROAD MEDICARE
TX
Enumeration date
03/05/2007
Last updated
07/07/2016
Update your record
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