MEDICARE: PEDRO LOPEZ III LPTA

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	225200000X	Physical Therapy Assistant	2110331	TX

General Provider Information

NPI Number	:	1841687670
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PEDRO LOPEZ III LPTA

Provider Business Mailing Address
First Line	:	227 W GRAY ST
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77019-5453
Country	:	US
Telephone Number	:	832-482-7986
Fax Number	:

Provider Business Practice Location Address
First Line	:	25140 KINGSLAND BLVD
Second Line	:
City	:	KATY
State	:	TX
Zip	:	77494-8472
Country	:	US
Telephone Number	:	832-768-1821
Fax Number	:

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

Provider Enumeration Date	:	04/20/2015
Last Update Date	:	03/16/2025

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