Individual
MARIELISA LOPEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
5151 HARRY HINES BOULEVARD CS6.104C, DALLAS, TX 75390-8860
(214) 645-1711
Mailing address
5151 HARRY HINES BOULEVARD CS6.104C, DALLAS, TX 75390-8860
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
Q9854
TX
Other
Enumeration date
11/29/2011
Last updated
03/16/2020
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