Individual
JEANETTE LOPEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1759 BROAD PARK CIR S STE 201, MANSFIELD, TX 76063-7834
(682) 341-3910
Mailing address
1759 BROAD PARK CIR S STE 201, MANSFIELD, TX 76063-7834
(682) 341-3910
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
817469
TX
363A00000X
Physician Assistant
Primary
PA20199
TX
Other
Enumeration date
12/29/2025
Last updated
05/01/2026
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