Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 122300000X | Dentist | 30010 | TX |
Y | 1223S0112X | Oral and Maxillofacial Surgeon | 30010 | TX |
N | 208200000X | Surgeon | BP10060738 | TX |
N | 208600000X | Surgeon | BP10060738 | TX |
NPI | 1043625569 |
---|---|
Provider Name | Dr. Luisa Noemi Rios |
First Address | Dallas, TX 75246-2013 |
Second Address | Dallas, TX 75246-2013 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/06/2014 |
Last Update Date | 22/08/2019 |