Provider Information for 1811445828
The following NPI(s) contain information matching your search criteria. Please select the NPI to view all the data associated with the NPI.
Please Note: Issuance of an NPI does not ensure or validate that the Health Care Provider is Licensed or Credentialed. For more information please refer to NPI: What You Need to Know
Mr. KEITH RIVERS L.P.C.
Sex: Male
NPI: 1811445828
Last Updated: 2016-09-19
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| NPI | 1811445828 | ||||||||
| Enumeration Date | 2016-09-19 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | YES | ||||||||
| Status | Active | ||||||||
| Mailing Address | 11205 COLTON AVE LUBBOCK, TX 79424-1186 United States Phone: 806-470-5162 | Fax:806-740-1471 | ||||||||
| Primary Practice Address | 5701 AVENUE P LUBBOCK, TX 79412-3674 United States Phone: 806-747-3488 | Fax: | ||||||||
| Secondary Practice Address(es) | |||||||||
| Health Information Exchange |
| ||||||||
| Other Identifiers |
| ||||||||
| Taxonomy |
|