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NPI Code Detail

MEDICARE: MIGUEL ANTONIO LOPEZ RN

MEDICARE: MIGUEL ANTONIO LOPEZ RN
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
1163W00000XRegistered Nurse1013937TX

General Provider Information

NPI Number : 1316879497
Entity Type Code : Individual
Provider Name (Legal Business Name) : MIGUEL ANTONIO LOPEZ RN
Provider Business Mailing Address
First Line : 9801 STONELAKE BLVD APT 1016
Second Line :
City : AUSTIN
State : TX
Zip : 78759-6579
Country : US
Telephone Number : 737-229-3460
Fax Number : 737-229-3544
Provider Business Practice Location Address
First Line : 9835 N LAKE CREEK PKWY
Second Line :
City : AUSTIN
State : TX
Zip : 78717-6210
Country : US
Telephone Number : 737-229-3460
Fax Number : 737-229-3544
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/02/2026
Last Update Date : 06/02/2026

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