Provider Demographics
NPI:1104301191
Name:RIOS, TRINITY RAE
Entity type:Individual
Prefix:
First Name:TRINITY
Middle Name:RAE
Last Name:RIOS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6802 UTSA BLVD APT 3107
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78249-1551
Mailing Address - Country:US
Mailing Address - Phone:361-424-4905
Mailing Address - Fax:
Practice Address - Street 1:6802 UTSA BLVD APT 3107
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78249-1551
Practice Address - Country:US
Practice Address - Phone:361-424-4905
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-26
Last Update Date:2018-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX344217164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse