Healthcare Provider Details

I. General information

NPI: 1447183728
Provider Name (Legal Business Name): ALEXANDER LOPEZ MAESTAS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/05/2026
Last Update Date: 06/05/2026
Certification Date: 06/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4304 AUSTIN BLUFFS PKWY
COLORADO SPRINGS CO
80918-2932
US

IV. Provider business mailing address

4304 AUSTIN BLUFFS PKWY
COLORADO SPRINGS CO
80918-2932
US

V. Phone/Fax

Practice location:
  • Phone: 719-445-9898
  • Fax:
Mailing address:
  • Phone: 719-445-9898
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: