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Individual

DR. SERGIO ENRIQUE LOPEZ

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DDS

Contact information

Practice address
1507 S MCCOLL RD, EDINBURG, TX 78541-4265
(956) 720-4345
(956) 720-4329
Mailing address
302 BOB BULLOCK LOOP, APT. 8101, LAREDO, TX 78043-4265
(956) 212-3662

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
27129
TX
1223P0221X
Pediatric Dentistry
Primary
27129
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
295598107
TX
Enumeration date
07/12/2011
Last updated
06/30/2021
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