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General NPI Number Information
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NPI Number | 1750657938
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Entity Type | Individual
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Provider Name | ANN MARGUERITE LOPEZ D.O.
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Gender | Female
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Dates
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Enumeration Date | 04/01/2012
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Last Update Date | 12/20/2023
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Provider Practice Location Address
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Address Line | 100 HOSPITAL AVE
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City | DU BOIS
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State | PA
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Zip | 15801
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Country | US
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Telephone | 814-371-2200
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Fax |
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Provider Business Mailing Address
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Address Line | 620 SAN GABRIEL OVERLOOK E
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City | GEORGETOWN
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State | TX
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Zip | 78628-7638
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Country | US
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Telephone | 512-630-6333
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Fax | 817-735-1880
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | OT018098
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | S5419
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | S5419
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License Number State | TX
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