Individual
DR. MANDY NOORI RIECK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
5200 HARRY HINES BLVD, DALLAS, TX 75284-2017
(214) 648-9741
(214) 648-9531
Mailing address
3500 GASTON AVE, 4 ROBERTS, DALLAS, TX 75246-2017
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
P6587
TX
208M00000X
Hospitalist Physician
Primary
P6587
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3297400-01
—
TX
05
—
329740006
—
TX
01
—
P01609442
RAILROAD MEDICARE
TX
Enumeration date
04/23/2010
Last updated
01/28/2019
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