Provider Demographics
NPI:1881573533
Name:DIAZ DEL RIEGO, MILDREY
Entity type:Individual
Prefix:
First Name:MILDREY
Middle Name:
Last Name:DIAZ DEL RIEGO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15482 SICOMORO VIEJO ST
Mailing Address - Street 2:
Mailing Address - City:CHANNELVIEW
Mailing Address - State:TX
Mailing Address - Zip Code:77530-1100
Mailing Address - Country:US
Mailing Address - Phone:713-498-7054
Mailing Address - Fax:
Practice Address - Street 1:3535 BRIARPARK DR STE 248
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77042-5241
Practice Address - Country:US
Practice Address - Phone:832-800-3058
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-28
Last Update Date:2025-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1158747163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse