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General NPI Number Information
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NPI Number | 1134758477
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Entity Type | Individual
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Provider Name | JOSEPH TRINIDAD LOPEZ
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Gender | Male
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Dates
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Enumeration Date | 04/08/2020
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Last Update Date | 04/08/2020
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Provider Practice Location Address
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Address Line | 524 SINGING OAKS STE 210
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City | BULVERDE
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State | TX
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Zip | 78070-6533
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Country | US
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Telephone | 830-256-7578
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Fax |
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Provider Business Mailing Address
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Address Line | 790 REMINGTON BLVD
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City | BOLINGBROOK
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State | IL
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Zip | 60440-4909
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Country | US
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Telephone |
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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