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General NPI Number Information
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NPI Number | 1588160295
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Entity Type | Individual
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Provider Name | HEATHER DAVIS-LOPEZ PA-C
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Gender | Female
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Dates
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Enumeration Date | 04/02/2018
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Last Update Date | 03/07/2022
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Provider Practice Location Address
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Address Line | 293 E TRENTON RD STE 20
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City | EDINBURG
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State | TX
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Zip | 78539-9762
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Country | US
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Telephone | 956-348-0140
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Fax | 956-292-0700
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Provider Business Mailing Address
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Address Line | 293 E TRENTON RD STE 20
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City | EDINBURG
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State | TX
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Zip | 78539-9762
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Country | US
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Telephone | 956-348-0140
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA11899
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License Number State |
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