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NPI Code Detail

MEDICARE: DANIELLE PURCELL LOPEZ PA

MEDICARE: DANIELLE PURCELL LOPEZ PA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363A00000XPhysician AssistantPA10899TX

General Provider Information

NPI Number : 1003351057
Entity Type Code : Individual
Provider Name (Legal Business Name) : DANIELLE PURCELL LOPEZ PA
Provider Business Mailing Address
First Line : 2332 BEVERLY HILLS DR
Second Line :
City : FORT WORTH
State : TX
Zip : 76114-1756
Country : US
Telephone Number : 817-378-0855
Fax Number : 817-378-0861
Provider Business Practice Location Address
First Line : 2332 BEVERLY HILLS DR
Second Line :
City : FORT WORTH
State : TX
Zip : 76114-1756
Country : US
Telephone Number : 817-378-0855
Fax Number : 817-378-0861
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/30/2016
Last Update Date : 03/16/2023

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Directions to “ DANIELLE PURCELL LOPEZ PA” Practice Location

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