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General NPI Number Information
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NPI Number | 1255086351
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Entity Type | Individual
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Provider Name | GABRIELA LOPEZ-JAIMEZ MD
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Gender | Female
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Dates
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Enumeration Date | 02/16/2022
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Last Update Date | 03/31/2025
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Provider Practice Location Address
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Address Line | 1 CHILDRENS WAY # 512-19A
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City | LITTLE ROCK
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State | AR
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Zip | 72202-3500
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Country | US
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Telephone | 501-364-5115
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Fax | 501-364-3196
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Provider Business Mailing Address
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Address Line | 3607 GREYSTONE DR APT 2027
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City | AUSTIN
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State | TX
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Zip | 78731-2233
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Country | US
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Telephone | 512-354-0062
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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 | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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