Individual
DR. LUIS NIEVES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1717 PRECINCT LINE RD STE 204, HURST, TX 76054-3169
(855) 549-7246
(817) 514-1901
Mailing address
4730 N HABANA AVE, STE 204, TAMPA, FL 33614-7163
(813) 549-2134
(813) 864-4436
Taxonomy
Speciality
Code
Description
License number
State
207QS0010X
Sports Medicine (Family Medicine) Physician
M7476
TX
208VP0014X
Interventional Pain Medicine Physician
Primary
M7476
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
196884602
—
TX
Enumeration date
08/26/2007
Last updated
05/05/2016
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