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General NPI Number Information
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NPI Number | 1790835692
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Entity Type | Individual
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Provider Name | ABDIEL LOPEZ D.M.D.
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Gender | Male
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Dates
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Enumeration Date | 01/11/2007
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Last Update Date | 02/03/2017
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Provider Practice Location Address
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Address Line | 3030 LBJ FWY SUITE 1400
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City | DALLAS
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State | TX
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Zip | 75234-7781
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Country | US
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Telephone | 972-663-5373
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Fax | 972-243-6059
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Provider Business Mailing Address
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Address Line | 11718 E STREAMERTAIL CIR
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City | CYPRESS
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State | TX
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Zip | 77433-6732
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Country | US
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Telephone | 787-627-6215
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 32622
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License Number State | TX
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