Healthcare Provider Details

I. General information

NPI: 1396888731
Provider Name (Legal Business Name): FRANK W. LOPEZ, MD, APMC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/15/2007
Last Update Date: 08/06/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3505 5TH AVE SUITE A-1
LAKE CHARLES LA
70607-2156
US

IV. Provider business mailing address

3505 5TH AVE SUITE A-1
LAKE CHARLES LA
70607-2156
US

V. Phone/Fax

Practice location:
  • Phone: 337-436-7560
  • Fax: 337-433-9861
Mailing address:
  • Phone: 337-436-7560
  • Fax: 337-433-9861

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number9855R
License Number StateLA

VIII. Authorized Official

Name: DR. FRANK WILLIAM LOPEZ
Title or Position: OWNER
Credential: MD
Phone: 337-475-7598