Healthcare Provider Details

I. General information

NPI: 1750307831
Provider Name (Legal Business Name): ALFREDO LOPEZ JR. MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/14/2006
Last Update Date: 06/04/2025
Certification Date: 06/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2010 S CYNTHIA ST STE 110
MCALLEN TX
78503-1387
US

IV. Provider business mailing address

2010 S CYNTHIA ST STE 110
MCALLEN TX
78503-1387
US

V. Phone/Fax

Practice location:
  • Phone: 956-687-6963
  • Fax: 956-683-7185
Mailing address:
  • Phone: 956-687-6963
  • Fax: 956-683-7185

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License NumberK5339
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberK5339
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: