Individual
MRS. ELIZABETH RIVERA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
3308 DEEN RD, FORT WORTH, TX 76106
(817) 702-1100
Mailing address
PO BOX 732973, DALLAS, TX 75373-2973
(817) 702-8450
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
P8074
TX
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/05/2011
Last updated
03/21/2019
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