Individual
JENNIFER A LOPEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1616 N ALABAMA RD, WHARTON, TX 77488-3204
(979) 282-2883
Mailing address
1701 LYNN ST, P O BOX 931, EL CAMPO, TX 77437-9339
(979) 332-0649
Taxonomy
Speciality
Code
Description
License number
State
183700000X
Pharmacy Technician
Primary
156150
TX
Other
Enumeration date
09/09/2013
Last updated
09/09/2013
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