Provider Demographics
NPI:1902593841
Name:RIVAS, BRENDA GISELLA (NP)
Entity type:Individual
Prefix:
First Name:BRENDA
Middle Name:GISELLA
Last Name:RIVAS
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13656 BRETON RIDGE ST # A&H
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77070-6081
Mailing Address - Country:US
Mailing Address - Phone:281-429-8780
Mailing Address - Fax:
Practice Address - Street 1:13656 BRETON RIDGE ST # A&H
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77070-6081
Practice Address - Country:US
Practice Address - Phone:281-429-8780
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-20
Last Update Date:2025-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX899612163W00000X
TX1179913363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No163W00000XNursing Service ProvidersRegistered Nurse