MEDICARE: DR. ARNALDO ANTONIO LOPEZ JR. DC

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	111N00000X	Chiropractor	12455	TX
2	111NN0400X	Neurology Chiropractor	12455	TX

General Provider Information

NPI Number	:	1699104299
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ARNALDO ANTONIO LOPEZ JR. DC

Provider Business Mailing Address
First Line	:	1809 FRANKLIN ST
Second Line	:
City	:	IRVING
State	:	TX
Zip	:	75060-5921
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	222 LAS COLINAS BLVD W STE 1650
Second Line	:
City	:	IRVING
State	:	TX
Zip	:	75039-5436
Country	:	US
Telephone Number	:	817-821-0004
Fax Number	:

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

Provider Enumeration Date	:	11/04/2013
Last Update Date	:	11/04/2013

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