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General NPI Number Information
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NPI Number | 1134913346
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Entity Type | Individual
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Provider Name | ARACELI MONIQUE FUENTES-LOPEZ PA-C
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Gender | Female
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Dates
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Enumeration Date | 04/04/2025
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Last Update Date | 01/05/2026
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Provider Practice Location Address
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Address Line | 11673 JOLLYVILLE RD STE B201
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City | AUSTIN
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State | TX
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Zip | 78759-4200
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Country | US
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Telephone | 512-579-0304
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Fax | 512-579-0320
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Provider Business Mailing Address
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Address Line | 11673 JOLLYVILLE RD STE B201
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City | AUSTIN
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State | TX
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Zip | 78759-4200
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Country | US
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Telephone | 512-579-0304
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Fax | 512-579-0320
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 806164
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License Number State | TX
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