Search › Texas › 104100000X
Kellye Rivera
NPI 1508785833 · on the registry since 2026 · sole proprietor
Practice
- Address
- 2204 Park Place Ave Ste B
Fort Worth, TX 76110 - Phone
- (682) 252-3830
- Clinicians at this address
- 3
Additional practice sites
- 6421 Camp Bowie Blvd Ste 416, Fort Worth, TX
Registry record
- Primary taxonomy
- 104100000X
104100000X
- Licence states on file
- TX
From the registry's licence fields, which are often incomplete.
- Sex
- Female
- Record last updated
- 2026-07-11
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Texas