Individual
DR. JUDITH MARIA MEDINA-RIVERA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.M.D.
Contact information
Practice address
11521 N FM 620 STE 700, AUSTIN, TX 78726-1147
(512) 560-0118
(512) 986-5102
Mailing address
11521 N FM 620 STE 700, AUSTIN, TX 78726-1147
(512) 560-0118
(512) 986-5102
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
23136
TX
122300000X
Dentist
2571
PR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1970006-03
—
TX
Enumeration date
06/29/2006
Last updated
12/11/2009
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