Individual
MR. ELEAZAR LOPEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
103A S KAIN ST, RIO GRANDE CITY, TX 78582-4221
(956) 488-9616
(956) 488-0572
Mailing address
PO BOX 827, 103-A KAIN STREET, RIO GRANDE CITY, TX 78582-0827
(956) 488-9616
(956) 488-0572
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
0086743
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
180887501
—
TX
05
—
180887502
—
TX
Enumeration date
04/02/2007
Last updated
05/29/2013
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