Individual
MRS. MARIVIC VINUYA LOPEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RNFA
Contact information
Practice address
10701 BLUESTONE RD, FORT WORTH, TX 76108-6930
(817) 692-9666
Mailing address
10701 BLUESTONE RD, FORT WORTH, TX 76108-6930
(817) 692-9666
Taxonomy
Speciality
Code
Description
License number
State
163WR0006X
Registered Nurse First Assistant
Primary
715412
TX
Other
Enumeration date
09/12/2012
Last updated
09/12/2012
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