Physician Compare National (NPI:1194761775)

HEALTHCARE PROVIDER: RENE LOPEZ M.D.

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1194761775
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	1254221583
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20120306000771
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	LOPEZ
	Individual professional last name
Provider First Name	RENE
	Individual professional first name
Provider Middle Name	B
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	UNIVERSITY OF ILLINOIS COLLEGE OF MED (CHI/PEOR/ROCK/CHM-URB)
	Individual professional's medical school
Graduation Year	1993
	Individual professional's medical school graduation year
Primary Specialty	EMERGENCY MEDICINE
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Organization Legal Name	VICTORIA EMERGENCY PARTNERS LLC
	Legal name of the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Group Practice PAC ID	7012165939
	Unique Group Practice ID assigned by PECOS to the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Number of Group Practice members	15
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	11212 STATE HWY 151
	Group Practice or individual's line 1 address
City	SAN ANTONIO
	Group Practice or individual's city
State	TX
	Group Practice or individual's state
Zip Code	782514498
	Group Practice or individual's zip code (9 digits when available)
Phone Number	8304267700
	Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	450237
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	CHRISTUS SANTA ROSA MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 1
Professional Accepts Medicare Assignment	Y