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Individual
MR. NELSON LOPEZ
Active
Individual
MR. NELSON LOPEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA00915
TX
363AS0400X
Surgical Physician Assistant
PA00915
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
80N377
BCBS
—
Enumeration date
10/04/2006
Last updated
03/04/2019
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