MEDICARE: ANA MARIE LOPEZ

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	363LF0000X	Family Nurse Practitioner	1056661	TX

General Provider Information

NPI Number	:	1952063646
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANA MARIE LOPEZ

Provider Business Mailing Address
First Line	:	4805 N 47TH ST
Second Line	:
City	:	MCALLEN
State	:	TX
Zip	:	78504-4865
Country	:	US
Telephone Number	:	956-784-0250
Fax Number	:

Provider Business Practice Location Address
First Line	:	5506 S JACKSON RD
Second Line	:
City	:	EDINBURG
State	:	TX
Zip	:	78539-9902
Country	:	US
Telephone Number	:	956-661-0066
Fax Number	:

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

Provider Enumeration Date	:	10/10/2021
Last Update Date	:	10/10/2021

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Directions to “ ANA MARIE LOPEZ ” Practice Location

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