MEDICARE: MARIA LOPEZ

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	106S00000X	Behavior Technician		TX

General Provider Information

NPI Number	:	1710840533
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARIA LOPEZ

Provider Business Mailing Address
First Line	:	12211 SUMMER CREEK TRACE DR
Second Line	:	APT 6209
City	:	HOUSTON
State	:	TX
Zip	:	77044
Country	:	US
Telephone Number	:	855-832-6727
Fax Number	:

Provider Business Practice Location Address
First Line	:	10777 WESTHEIMER RD, SUITE 1100
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77042
Country	:	US
Telephone Number	:	855-832-6727
Fax Number	:

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

Provider Enumeration Date	:	12/08/2025
Last Update Date	:	12/08/2025

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Directions to “ MARIA LOPEZ ” Practice Location

Language	Start Address	Practice Location

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