Organization
MV LOPEZ RNFA PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARIVIC LOPEZ RNFA (MANAGER)
(817) 692-9666
Entity
Organization
Contact information
Practice address
10701 BLUESTONE RD, FORT WORTH, TX 76108-6930
(817) 692-9666
Mailing address
PO BOX 150896, FORT WORTH, TX 76108-0896
(817) 692-9666
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
715412
TX
Other
Enumeration date
10/19/2015
Last updated
10/19/2015
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