Provider Demographics
NPI:1154709715
Name:JOSEPH, RIYA AUGUSTIN
Entity type:Individual
Prefix:
First Name:RIYA
Middle Name:AUGUSTIN
Last Name:JOSEPH
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 1:2121 S BUCKNER BLVD
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75227-8602
Mailing Address - Country:US
Mailing Address - Phone:214-381-1187
Mailing Address - Fax:214-381-7213
Practice Address - Street 1:2121 S BUCKNER BLVD
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75227-8602
Practice Address - Country:US
Practice Address - Phone:214-381-1187
Practice Address - Fax:214-381-7213
Is Sole Proprietor?:No
Enumeration Date:2015-05-14
Last Update Date:2023-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXBP10053372207R00000X
TXR6585207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine