Individual
JACOB AARON RIVERA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
6201 HARRY HINES BLVD, DALLAS, TX 75235-5202
(214) 633-5555
Mailing address
3500 CAMP BOWIE BLVD, FORT WORTH, TX 76107-2644
(817) 735-2171
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA17963
TX
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
02/29/2024
Last updated
05/07/2024
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