Provider Demographics
NPI:1174961726
Name:RIOS, MARITA ANDREA (MD)
Entity type:Individual
Prefix:
First Name:MARITA
Middle Name:ANDREA
Last Name:RIOS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8711 VILLAGE DR STE 114
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78217-5419
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:19707 I-10 W
Practice Address - Street 2:#213
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78257
Practice Address - Country:US
Practice Address - Phone:210-946-3100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-06-05
Last Update Date:2025-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXBP10046114207Q00000X
TXQ8338207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine