Healthcare Provider Details

I. General information

NPI: 1528606720
Provider Name (Legal Business Name): NOEMI LOPEZ NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/18/2019
Last Update Date: 12/18/2019
Certification Date: 12/18/2019
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3002 N BUSINESS 281 STE B
EDINBURG TX
78541-7162
US

IV. Provider business mailing address

3002 N BUSINESS 281 STE B
EDINBURG TX
78541-7162
US

V. Phone/Fax

Practice location:
  • Phone: 956-383-8300
  • Fax: 956-383-3006
Mailing address:
  • Phone: 956-383-8300
  • Fax: 956-383-3006

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAP143992
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: