Individual
ELIOT J LOPEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
3939 MEDICAL DR, SAN ANTONIO, TX 78229-2291
(210) 450-6120
(210) 450-6161
Mailing address
7703 FLOYD CURL DR, SAN ANTONIO, TX 78229-3901
(210) 450-6120
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
36350
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
363422201
—
TX
01
—
363422202
CSHCN
TX
Enumeration date
08/10/2016
Last updated
11/09/2016
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