Provider Demographics
NPI:1962559088
Name:RIELA, ANTHONY RICHARD (MD)
Entity type:Individual
Prefix:
First Name:ANTHONY
Middle Name:RICHARD
Last Name:RIELA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4032 MCDERMOTT RD
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75024-7733
Mailing Address - Country:US
Mailing Address - Phone:972-769-9000
Mailing Address - Fax:972-769-0035
Practice Address - Street 1:4032 MCDERMOTT RD
Practice Address - Street 2:SUITE 100
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75024-7733
Practice Address - Country:US
Practice Address - Phone:972-769-9000
Practice Address - Fax:972-769-0035
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-03
Last Update Date:2016-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH78172084N0402X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0402XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology with Special Qualifications in Child Neurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXC86155Medicare UPIN