Healthcare Provider Details

I. General information

NPI: 1518761899
Provider Name (Legal Business Name): MONICA OLVERA LOPEZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/03/2025
Last Update Date: 04/03/2025
Certification Date: 04/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2102 TREASURE HILLS BLVD
HARLINGEN TX
78550-8736
US

IV. Provider business mailing address

2901 HAINE DR APT 702
HARLINGEN TX
78550-7815
US

V. Phone/Fax

Practice location:
  • Phone: 956-296-1491
  • Fax:
Mailing address:
  • Phone: 956-866-7743
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number802579
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: