MEDICARE: TANIA LOPEZ FNP

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	207Q00000X	Family Medicine Physician	1219256	TX

General Provider Information

NPI Number	:	1285598276
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TANIA LOPEZ FNP

Provider Business Mailing Address
First Line	:	15242 LOYS COVES CT
Second Line	:
City	:	HUMBLE
State	:	TX
Zip	:	77396-6127
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2002 S WAYSIDE DR # B
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77023-3905
Country	:	US
Telephone Number	:	713-803-1840
Fax Number	:

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

Provider Enumeration Date	:	12/12/2025
Last Update Date	:	12/12/2025

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