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1568249969
JOHAN ERNESTO RIVERA
ROUND ROCK, TX
NPI
1568249969
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
(Licence: TX PA17137)
Enumeration Date
2023-09-11
Last Update Date
2023-10-05
Business Address
JOHAN ERNESTO RIVERA PA
3950 N A W GRIMES BLVD STE N201
ROUND ROCK, TX 78665-3540
Phone number: 877-800-5722
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Mailing Address
JOHAN ERNESTO RIVERA PA
205 E UNIVERSITY AVE STE 200
GEORGETOWN, TX 78626-6821
Phone number: 512-994-1933
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