De Riese, Cornelia Selma
De Riese, Cornelia Selma is an individual health care provider with primary practice located at 701 W 5Th St , Odessa TX 79763-4206. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Obstetrics & Gynecology, Allopathic & Osteopathic Physicians / Female Pelvic Medicine and Reconstructive Surgery. Allopathic & Osteopathic Physicians / Female Pelvic Medicine and Reconstructive Surgery is her primary health care specialty. De Riese, Cornelia Selma can be contacted via phone (432) 335-2222.Contact Information
Primary practice address
701 W 5Th St
Odessa TX 79763-4206
Phone: (432) 335-2222
Fax: (432) 335-1009
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Obstetrics & Gynecology | 207V00000X | L6348 | Texas |
| Allopathic & Osteopathic Physicians / Female Pelvic Medicine and Reconstructive Surgery | 207VF0040X | L6348 | Texas |
Profile Details
| NPI number | 1841280716 |
|---|---|
| LBN Legal business name | De Riese, Cornelia Selma |
| Credentials | MD, PHD, MBA |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 24th, 2005 |
| Last updated | Apr 30th, 2021 - about 5 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1841280716 | NPPES |
| Texas | MEDICAID | 111572100 | |
| Texas | Other | 111572101 | |
| Texas | Other | A117 | |
| Texas | MEDICAID | 103816802 | |
| Texas | MEDICAID | 103816803 | |
| Texas | MEDICAID | 84497 | |
| Texas | MEDICAID | 000K5175 | |
| Texas | Other | 83G037 | |
| Texas | Other | 84497 | |
| Texas | MEDICAID | 100048670A | |
| Texas | Other | 80833Z |
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