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Individual

MS. TANIA LOPEZ

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
1201 RANCH TRL, IRVING, TX 75063-7353
(972) 831-0220
Mailing address
703 WALNUT BEND DR, MANSFIELD, TX 76063-5891
(817) 602-1147

Taxonomy

Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary

Other

Enumeration date
09/24/2018
Last updated
09/24/2018
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