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General NPI Number Information
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NPI Number | 1174104582
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Entity Type | Individual
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Provider Name | FREDERIED RIVERA LOPEZ APRN, FNP-BC,AAHIVS
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Gender | Male
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Dates
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Enumeration Date | 04/16/2021
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Last Update Date | 12/26/2025
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Provider Practice Location Address
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Address Line | 25700 INTERSTATE 45 STE 4032
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City | THE WOODLANDS
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State | TX
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Zip | 77386-1364
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Country | US
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Telephone | 936-217-0353
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Fax |
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Provider Business Mailing Address
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Address Line | 25700 INTERSTATE 45 STE 4032
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City | THE WOODLANDS
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State | TX
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Zip | 77386-1364
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Country | US
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Telephone | 936-217-0353
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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 | 1174920
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License Number State | TX
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