Individual
DR. MARK B RILEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2803 EARL RUDDER FWY S STE 103, COLLEGE STATION, TX 77845-6099
(979) 731-8888
(979) 731-8848
Mailing address
2803 EARL RUDDER FWY S STE 103, COLLEGE STATION, TX 77845-6099
(979) 731-8888
(979) 731-8848
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
F3306
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110280806
—
TX
01
—
8U5904
BLUE CROSS BLUE SHIELD
TX
01
—
P00410987
RAILROAD MEDICARE
TX
Enumeration date
10/12/2006
Last updated
08/12/2015
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