Organization
DIEGO RIVERA, M.D., P.A.
Active
Other names
University Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DIEGO RIVERA M.D. (OWNER)
(806) 747-4415
Entity
Organization
Contact information
Practice address
111 UNIVERSITY AVE, LUBBOCK, TX 79415
(806) 747-4415
(806) 747-1304
Mailing address
111 UNIVERSITY AVE, LUBBOCK, TX 79415
(806) 747-4415
(806) 747-1304
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
G1757
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
010066279
RAILROAD MEDICARE
TX
05
—
158775001
—
TX
Enumeration date
12/26/2007
Last updated
05/07/2008
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