Basic Information
| Provider Information | |||||||||
| NPI: | 1568457570 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | RIOS-SIERRA | ||||||||
| FirstName: | CARLOS | ||||||||
| MiddleName: | EDUARDO | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 14311 HORIZON FALLS LN | ||||||||
| Address2: | |||||||||
| City: | HUMBLE | ||||||||
| State: | TX | ||||||||
| PostalCode: | 773963038 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7138298877 | ||||||||
| FaxNumber: | 2816055792 | ||||||||
| Practice Location | |||||||||
| Address1: | 14311 HORIZON FALLS LN | ||||||||
| Address2: | |||||||||
| City: | HUMBLE | ||||||||
| State: | TX | ||||||||
| PostalCode: | 773963038 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7138298877 | ||||||||
| FaxNumber: | 2816055792 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/15/2005 | ||||||||
| LastUpdateDate: | 12/15/2015 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207L00000X | L1441 | TX | Y | Allopathic & Osteopathic Physicians | Anesthesiology | 207LP2900X | L1441 | TX | N | Allopathic & Osteopathic Physicians | Anesthesiology | Pain Medicine |
ID Information
| ID | Type | State | Issuer | Description | BR6190502 | 01 | DEA | OTHER | 8B8942 | 01 | TX | BLUE CROSS BLUE SHIELD | OTHER | 579065262 | 01 | TX | TRICARE INSURANCE | OTHER | 144977901 | 05 | TX | MEDICAID | M0118330 | 01 | TX | DPS | OTHER |