Provider Demographics
NPI:1215424155
Name:RIVAS, TERRI HENRY
Entity type:Individual
Prefix:
First Name:TERRI
Middle Name:HENRY
Last Name:RIVAS
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:TERRI
Other - Middle Name:HENRY
Other - Last Name:JENKINS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 12028
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77391-2028
Mailing Address - Country:US
Mailing Address - Phone:832-264-2335
Mailing Address - Fax:
Practice Address - Street 1:20911 CORAL BRIDGE LN
Practice Address - Street 2:
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77388-5318
Practice Address - Country:US
Practice Address - Phone:832-264-2335
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-17
Last Update Date:2018-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
No3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider
No385H00000XRespite Care FacilityRespite Care