1306945837 NPI number — MS. MARIA PILAR RIVERA MS, LPC

Table of content: MS. MARIA PILAR RIVERA MS, LPC (NPI 1306945837)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1306945837 NPI number — MS. MARIA PILAR RIVERA MS, LPC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
RIVERA
Provider First Name:
MARIA
Provider Middle Name:
PILAR
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
MS, LPC
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
RIVERA
Provider Other First Name:
M
Provider Other Middle Name:
PILAR
Provider Other Name Prefix Text:
MS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
LPC
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1306945837
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/04/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
643 S. BIRDSONG
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SAN ANTONIO
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
78258
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
210-355-4727
Provider Business Mailing Address Fax Number:
210-257-6560

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
7272 WURZBACH ROAD
Provider Second Line Business Practice Location Address:
SUITE 1504
Provider Business Practice Location Address City Name:
SAN ANTONIO
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78240
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
210-647-7707
Provider Business Practice Location Address Fax Number:
210-647-7805
Provider Enumeration Date:
09/21/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 101Y00000X , with the licence number:  15887 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 101YP2500X , with the licence number: 15887 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 028584301 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".




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