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General NPI Number Information
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NPI Number | 1720930613
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Entity Type | Individual
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Provider Name | OMAR LOPEZ-FLORES APRN
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Gender | Male
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Dates
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Enumeration Date | 02/12/2026
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Last Update Date | 02/12/2026
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Provider Practice Location Address
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Address Line | 5450 CLEARFORK MAIN ST STE 420
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City | FORT WORTH
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State | TX
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Zip | 76109-3569
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Country | US
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Telephone | 817-784-8268
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Fax |
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Provider Business Mailing Address
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Address Line | 3962 FARRIS CT
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City | FORT WORTH
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State | TX
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Zip | 76133-1210
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Country | US
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Telephone | 817-784-8268
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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 | 208800000X
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Taxonomy Name | Urology Physician
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License Number | 1206448
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License Number State | TX
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