Individual
MR. MICHAEL BEN ANDREW RILEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LSA, CSA
Contact information
Practice address
8215 LICHEN LN, SPRING, TX 77379-4517
(832) 559-3870
Mailing address
PO BOX 11807, SPRING, TX 77391-1807
(713) 992-1086
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
SA00319
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0027SX
BLUE CROSS BLUE SHIELD
—
Enumeration date
04/28/2008
Last updated
02/20/2014
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