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NPI Code Detail

MEDICARE: CHRISTOPHER LOPEZ ATC, LAT

MEDICARE:   CHRISTOPHER  LOPEZ  ATC, LAT
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
12255A2300XAthletic TrainerAT3154TX

General Provider Information

NPI Number : 1629042510
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHRISTOPHER LOPEZ ATC, LAT
Provider Business Mailing Address
First Line : 3765 TIERRA ISELA
Second Line :
City : EL PASO
State : TX
Zip : 79938
Country : US
Telephone Number : 915-921-1308
Fax Number :
Provider Business Practice Location Address
First Line : 13981 SOCORRO RD.
Second Line :
City : SAN ELIZARIO
State : TX
Zip : 79849
Country : US
Telephone Number : 915-872-3939
Fax Number : 915-872-3971
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/15/2006
Last Update Date : 07/08/2007

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Directions to “ CHRISTOPHER LOPEZ ATC, LAT” Practice Location

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