Healthcare Provider Details

I. General information

NPI: 1730279068
Provider Name (Legal Business Name): EVA J LOPEZ M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/16/2006
Last Update Date: 07/23/2026
Certification Date: 07/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5401 SOUTH ST
LINCOLN NE
68506-2150
US

IV. Provider business mailing address

2318 SAN PEDRO AVE STE 12
SAN ANTONIO TX
78212-1901
US

V. Phone/Fax

Practice location:
  • Phone: 210-259-6338
  • Fax: 386-204-7372
Mailing address:
  • Phone: 210-259-6338
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2083B0002X
TaxonomyObesity Medicine (Preventive Medicine) Physician
License NumberH4499
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberE-9796
License Number StateAR
# 3
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberH4499
License Number StateTX
# 4
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number30368
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: