Provider Demographics
NPI:1922277789
Name:RIVAS, JOHN (RRT)
Entity Type:Individual
Prefix:MR
First Name:JOHN
Middle Name:
Last Name:RIVAS
Suffix:
Gender:M
Credentials:RRT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:11359 BEACH FRONT DR
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79936-3807
Mailing Address - Country:US
Mailing Address - Phone:915-588-8368
Mailing Address - Fax:
Practice Address - Street 1:3105 N YARBROUGH DR
Practice Address - Street 2:SUITE 101
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79925-3165
Practice Address - Country:US
Practice Address - Phone:915-595-6461
Practice Address - Fax:915-595-9901
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-26
Last Update Date:2008-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX598002279H0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2279H0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, RegisteredHome Health