Individual
LILIANA LOPEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
139 S HILL RIDGE RD, BASTROP, TX 78602-2689
(512) 596-7607
Mailing address
139 S HILL RIDGE RD, BASTROP, TX 78602-2689
(512) 596-7607
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
212652
TX
Other
Enumeration date
10/12/2018
Last updated
10/12/2018
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