Provider Demographics
NPI:1720800683
Name:RIVERA, THELMA ESPERANZA
Entity type:Individual
Prefix:
First Name:THELMA
Middle Name:ESPERANZA
Last Name:RIVERA
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 1:2111 WEST LOOP S STE 150
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77027-3647
Mailing Address - Country:US
Mailing Address - Phone:281-296-2131
Mailing Address - Fax:
Practice Address - Street 1:2111 WEST LOOP S STE 150
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77027-3647
Practice Address - Country:US
Practice Address - Phone:281-296-2131
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-30
Last Update Date:2024-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician