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Individual

DR. LUIS MANUEL RIOS JR.

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
2101 CORNERSTONE BLVD, EDINBURG, TX 78539-8301
(956) 682-3147
(956) 682-3511
Mailing address
2101 CORNERSTONE BLVD, EDINBURG, TX 78539-8301
(956) 682-3147
(956) 682-3511

Taxonomy

Speciality
Code
Description
License number
State
2086S0122X
Plastic and Reconstructive Surgery Physician
Primary
J0221
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0059GS
BLUE CROSS/BLUE SHIELD GROUP
TX
05
031479101
TX
05
152179101
TX
01
742883624
WORKERS COMP #
TX
01
742883624
FEDERAL TAX ID#
01
8B6021
BLUE CROSS PROVIDER #
TX
Enumeration date
08/19/2005
Last updated
11/09/2011
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