MEDICARE: ELIZABETH LOPEZ LMSW

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	1041C0700X	Clinical Social Worker	53171	TX
2	104100000X	Social Worker	53171	TX

General Provider Information

NPI Number	:	1588365225
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ELIZABETH LOPEZ LMSW

Provider Business Mailing Address
First Line	:	5900 BALCONES DR STE 100
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78731-4298
Country	:	US
Telephone Number	:	832-662-5498
Fax Number	:

Provider Business Practice Location Address
First Line	:	16693 HUFFMEISTER RD
Second Line	:
City	:	CYPRESS
State	:	TX
Zip	:	77429-1646
Country	:	US
Telephone Number	:	281-305-9387
Fax Number	:

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

Provider Enumeration Date	:	03/10/2023
Last Update Date	:	03/09/2026

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