MEDICARE: DR. ROWENA R LOPEZ D.C.

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
1	111N00000X	Chiropractor	10241	TX
2	111N00000X	Chiropractor	C000025	GU

General Provider Information

NPI Number	:	1114010410
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ROWENA R LOPEZ D.C.

Provider Business Mailing Address
First Line	:	8746 BACKCOVE CT
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77064-8893
Country	:	US
Telephone Number	:	281-216-2693
Fax Number	:

Provider Business Practice Location Address
First Line	:	6633 HILLCROFT ST
Second Line	:	SUITE 140
City	:	HOUSTON
State	:	TX
Zip	:	77081-4887
Country	:	US
Telephone Number	:	713-780-1186
Fax Number	:	713-484-7366

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/02/2006
Last Update Date	:	06/23/2009

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