Provider Demographics
NPI:1306141619
Name:RIOS, ESMERALDA (CDR)
Entity type:Individual
Prefix:
First Name:ESMERALDA
Middle Name:
Last Name:RIOS
Suffix:
Gender:F
Credentials:CDR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1205 HOOKS AVE
Mailing Address - Street 2:
Mailing Address - City:DONNA
Mailing Address - State:TX
Mailing Address - Zip Code:78537-3341
Mailing Address - Country:US
Mailing Address - Phone:956-461-6600
Mailing Address - Fax:956-461-6600
Practice Address - Street 1:1205 HOOKS AVE
Practice Address - Street 2:
Practice Address - City:DONNA
Practice Address - State:TX
Practice Address - Zip Code:78537-3341
Practice Address - Country:US
Practice Address - Phone:956-461-6600
Practice Address - Fax:956-461-6600
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-18
Last Update Date:2011-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDT06261133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered