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General NPI Number Information
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NPI Number | 1285243576
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Entity Type | Individual
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Provider Name | FATIMA LOPEZ DC
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Gender | Female
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Dates
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Enumeration Date | 07/23/2020
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Last Update Date | 07/17/2023
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Provider Practice Location Address
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Address Line | 4425 S MOPAC EXPY BLDG 3, STE 502A
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City | AUSTIN
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State | TX
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Zip | 78735
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Country | US
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Telephone | 512-308-6026
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 153152
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City | AUSTIN
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State | TX
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Zip | 78715-3152
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Country | US
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Telephone |
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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 | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 14309
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License Number State | TX
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