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NPI Code Detail

MEDICARE: DR. REBECCA LOPEZ PHD, LPA

MEDICARE: DR. REBECCA LOPEZ PHD, LPA
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
1101YM0800XMental Health Counselor34340TX
2103TH0004XHealth Psychologist34340TX

General Provider Information

NPI Number : 1629605936
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. REBECCA LOPEZ PHD, LPA
Provider Business Mailing Address
First Line : 11111 KATY FWY STE 910
Second Line :
City : HOUSTON
State : TX
Zip : 77079-2119
Country : US
Telephone Number : 713-568-8253
Fax Number : 713-955-4982
Provider Business Practice Location Address
First Line : 11111 KATY FWY STE 910
Second Line :
City : HOUSTON
State : TX
Zip : 77079-2119
Country : US
Telephone Number : 713-568-8253
Fax Number : 713-955-4982
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/25/2020
Last Update Date : 05/19/2021

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