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Individual

CHARLES MIKE RIOS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1100 S. MAIN ST. #103, GRAPEVINE, TX 76051
(817) 310-5510
(817) 310-5508
Mailing address
1100 S. MAIN ST. #103, GRAPEVINE, TX 76051
(817) 310-5510
(817) 310-5508

Taxonomy

Speciality
Code
Description
License number
State
2080P0006X
Developmental - Behavioral Pediatrics Physician
F5723
TX
2080P0008X
Pediatric Neurodevelopmental Disabilities Physician
Primary
F5723
TX

Other

Enumeration date
07/10/2007
Last updated
10/10/2012
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