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General NPI Number Information
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NPI Number | 1215519244
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Entity Type | Individual
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Provider Name | SAMANTHA LOPEZ
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Gender | Female
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Dates
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Enumeration Date | 04/28/2021
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Last Update Date | 06/12/2025
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Provider Practice Location Address
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Address Line | 864 CENTRAL BLVD STE 2800
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City | BROWNSVILLE
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State | TX
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Zip | 78520-7505
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Country | US
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Telephone | 956-525-7372
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Fax |
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Provider Business Mailing Address
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Address Line | 110 E SAVANNAH AVE BLDG B201
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City | MCALLEN
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State | TX
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Zip | 78503-1291
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Country | US
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Telephone | 956-627-3660
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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 | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | 8615
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License Number State | TX
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