Provider Demographics
NPI:1508059270
Name:RIVERA-ROBLES, JESSICA (OD)
Entity Type:Individual
Prefix:DR
First Name:JESSICA
Middle Name:
Last Name:RIVERA-ROBLES
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1141 NORTH LOOP 1604 E #105-437
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78232
Mailing Address - Country:US
Mailing Address - Phone:210-264-8768
Mailing Address - Fax:
Practice Address - Street 1:1515 N LOOP 1604 E
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78232-1431
Practice Address - Country:US
Practice Address - Phone:210-496-3336
Practice Address - Fax:210-496-3332
Is Sole Proprietor?:No
Enumeration Date:2007-08-24
Last Update Date:2020-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX7113T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist