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Organization
LOPEZ FAMILY PRACTICE
Active
Organization
LOPEZ FAMILY PRACTICE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JESUS ANTONIO LOPEZ MD (PRESIDENT/OWNER)
(210) 921-6088
Entity
Organization
Contact information
Practice address
601 LABOR ST, SAN ANTONIO, TX 78210-1313
(210) 921-6088
(210) 921-6019
Mailing address
601 LABOR ST, SAN ANTONIO, TX 78210-1313
(210) 921-6088
(210) 921-6019
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
L1649
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00203Q
BCBS OF TX
—
05
—
144083601
—
TX
Enumeration date
10/18/2007
Last updated
11/17/2008
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