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General NPI Number Information
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NPI Number | 1194225144
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Entity Type | Individual
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Provider Name | JAZMIN LOPEZ
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Gender | Female
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Dates
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Enumeration Date | 02/16/2018
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Last Update Date | 11/04/2024
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Provider Practice Location Address
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Address Line | 1512 N ZARAGOZA RD STE C1
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City | EL PASO
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State | TX
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Zip | 79936-8903
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Country | US
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Telephone | 915-855-0601
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Fax |
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Provider Business Mailing Address
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Address Line | 10644 ONYXSTONE ST
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City | EL PASO
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State | TX
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Zip | 79924-1685
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Country | US
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Telephone | 915-328-4874
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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 | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 121169
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License Number State | TX
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