MEDICARE: JOSE RIOJAS JR. OD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist	2476TG	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1124014279
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOSE RIOJAS JR. OD

Provider Business Mailing Address
First Line	:	355 N CEYLON ST
Second Line	:
City	:	EAGLE PASS
State	:	TX
Zip	:	78852-4503
Country	:	US
Telephone Number	:	830-773-1135
Fax Number	:	830-773-6244

Provider Business Practice Location Address
First Line	:	355 N CEYLON ST
Second Line	:
City	:	EAGLE PASS
State	:	TX
Zip	:	78852-4503
Country	:	US
Telephone Number	:	830-773-1135
Fax Number	:	830-773-6244

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/23/2005
Last Update Date	:	12/11/2009

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