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General NPI Number Information
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NPI Number | 1114449733
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Entity Type | Individual
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Provider Name | VIVIAN CASTANEDA LOPEZ FNP-C
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Gender | Female
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Dates
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Enumeration Date | 07/14/2017
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Last Update Date | 07/14/2017
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Provider Practice Location Address
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Address Line | 500 E AVENUE J
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City | ROBSTOWN
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State | TX
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Zip | 78380-2307
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Country | US
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Telephone | 361-767-9955
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Fax |
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Provider Business Mailing Address
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Address Line | 1810 BARLOW TRL
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City | CORPUS CHRISTI
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State | TX
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Zip | 78410-1872
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Country | US
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Telephone | 361-232-8475
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | AP134492
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License Number State | TX
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