Rivera, Walter Ivan

Rivera, Walter Ivan is an individual health care provider with primary practice located at 701 W 5Th St , Odessa TX 79763-4206. He recently has 2 registered licenses in different health care specialties including Student, Health Care / Student in an Organized Health Care Education/Training Program, Technologists, Technicians & Other Technical Service Providers / Surgical Assistant. Student, Health Care / Student in an Organized Health Care Education/Training Program is his primary health care specialty. Rivera, Walter Ivan can be contacted via phone (432) 703-5238.

Contact Information

Primary practice address
701 W 5Th St Odessa TX 79763-4206
Phone: (432) 703-5238
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Student, Health Care / Student in an Organized Health Care Education/Training Program 390200000X
Technologists, Technicians & Other Technical Service Providers / Surgical Assistant 246ZC0007X 19-259 Wisconsin

Profile Details

NPI number 1164089215
LBN Legal business name Rivera, Walter Ivan
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 23rd, 2019
Last updated Mar 30th, 2024 - about last year

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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1164089215 NPPES
Wisconsin Other 19-259 SURGICAL ASSISTANT

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