Provider Demographics
NPI:1326385311
Name:RIVAS, SERGIO ENRIQUE (FNP, MPH)
Entity type:Individual
Prefix:MR
First Name:SERGIO
Middle Name:ENRIQUE
Last Name:RIVAS
Suffix:
Gender:
Credentials:FNP, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16620 SAN PEDRO AVE STE 300
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78232-2679
Mailing Address - Country:US
Mailing Address - Phone:210-629-2295
Mailing Address - Fax:
Practice Address - Street 1:8542 WURZBACH RD
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78240-1241
Practice Address - Country:US
Practice Address - Phone:210-616-7300
Practice Address - Fax:210-616-7359
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-10
Last Update Date:2025-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP126067363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily