Individual
IDA LOPEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3201 CHERRY RIDGE ST STE D400, SAN ANTONIO, TX 78230-4820
(210) 692-0222
Mailing address
8730 ATWATER CRK, SAN ANTONIO, TX 78245-3249
(956) 455-2429
Taxonomy
Speciality
Code
Description
License number
State
163WH0200X
Home Health Registered Nurse
Primary
593318
TX
Other
Enumeration date
03/08/2018
Last updated
03/08/2018
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