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General NPI Number Information
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NPI Number | 1134275787
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Entity Type | Organization
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Legal Business Name | EMMA V. LOPEZ, D.D.S., P.A.
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Dates
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Enumeration Date | 01/26/2007
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Last Update Date | 03/16/2012
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Provider Practice Location Address
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Address Line | 5206 IRVINGTON BLVD STE. A
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City | HOUSTON
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State | TX
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Zip | 77009-1932
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Country | US
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Telephone | 713-742-0355
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Fax | 713-742-0357
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Provider Business Mailing Address
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Address Line | 5206 IRVINGTON BLVD STE. A
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City | HOUSTON
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State | TX
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Zip | 77009-1932
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Country | US
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Telephone | 713-742-0355
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Fax | 713-742-0357
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Authorized Official
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Title or Position | OWNER PRESIDENT
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Name | DR. EMMA VIRGINIA LOPEZ
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Credential | D.D.S.
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Telephone | 713-742-0355
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 18695
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License Number State | TX
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