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General NPI Number Information
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NPI Number | 1508050238
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Entity Type | Organization
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Legal Business Name | LUIS ALFONSO LOPEZ, MD, PA
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Dates
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Enumeration Date | 09/06/2007
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Last Update Date | 08/09/2018
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Provider Practice Location Address
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Address Line | 20642 STONE OAK PARKWAY STE 105
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City | SAN ANTONIO
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State | TX
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Zip | 78258
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Country | US
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Telephone | 210-650-0814
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Fax | 210-650-0926
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Provider Business Mailing Address
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Address Line | 20642 STONE OAK PARKWAY STE 105
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City | SAN ANTONIO
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State | TX
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Zip | 78258
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Country | US
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Telephone | 210-650-0814
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Fax | 210-650-0926
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Authorized Official
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Title or Position | PRESIDENT
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Name | LUIS A LOPEZ
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Credential | MD
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Telephone | 210-650-0814
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | K1530
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number |
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License Number State |
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