Organization
DOMICILLIARY SERVICE LLC
Active
Other names
DR. RIVERO AND ASSOCIATES II
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MANUEL S RIVERO M.D. (PRESIDENT)
(469) 595-9475
Entity
Organization
Contact information
Practice address
1513 VICEROY DR, DALLAS, TX 75235-2303
(469) 685-7020
(214) 920-8446
Mailing address
1513 VICEROY DR, DALLAS, TX 75235-2303
(469) 685-7020
(214) 920-8446
Taxonomy
Speciality
Code
Description
License number
State
173000000X
Legal Medicine
Primary
—
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DO1083
RAILROAD MEDICARE PTAN
—
Enumeration date
09/11/2007
Last updated
07/21/2022
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