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General NPI Number Information
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NPI Number | 1427575828
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Entity Type | Individual
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Provider Name | MAYRA LOPEZ
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Gender | Female
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Dates
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Enumeration Date | 08/25/2017
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Last Update Date | 11/12/2025
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Provider Practice Location Address
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Address Line | 4639 CORONA DR STE 41
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City | CORPUS CHRISTI
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State | TX
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Zip | 78411-5426
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Country | US
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Telephone | 361-204-3097
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Fax |
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Provider Business Mailing Address
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Address Line | 3706 LIBERTY BLVD
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City | PENITAS
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State | TX
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Zip | 78576-2001
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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 | 2355S0801X
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Taxonomy Name | Speech-Language Assistant
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License Number | 36745
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 2355S0801X
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Taxonomy Name | Speech-Language Assistant
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License Number |
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License Number State |
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