Provider Demographics
NPI:1144430927
Name:RIVERA, HUGO A (DDS)
Entity type:Individual
Prefix:DR
First Name:HUGO
Middle Name:A
Last Name:RIVERA
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:8606 VILLAGE DR STE B
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78217-5506
Mailing Address - Country:US
Mailing Address - Phone:210-654-6882
Mailing Address - Fax:210-654-0036
Practice Address - Street 1:315 N SAN SABA STE 202
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78207-3193
Practice Address - Country:US
Practice Address - Phone:210-223-3383
Practice Address - Fax:210-223-1055
Is Sole Proprietor?:No
Enumeration Date:2007-05-23
Last Update Date:2021-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX228591223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1906992-04Medicaid