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Individual
JUSTIN GUY RIVERA
Active
Individual
JUSTIN GUY RIVERA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHYSICIAN ASSISTANT
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
PA57420
CA
261QU0200X
Urgent Care Clinic/Center
PA14175
TX
363A00000X
Physician Assistant
Primary
PA14175
TX
Other
Enumeration date
10/29/2019
Last updated
01/16/2026
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