Individual
DANIEL L LOPEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
5625 BROADWAY ST, SUITE 1, SAN ANTONIO, TX 78209-5719
(210) 822-7321
(210) 736-1867
Mailing address
5625 BROADWAY ST, SUITE 1, SAN ANTONIO, TX 78209-5719
(210) 822-7321
(210) 736-1867
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
24076
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0004625076
AETNA
TX
01
—
276574
VALUE OPTIONS
TX
01
—
GO3C
BCBS
TX
Enumeration date
02/06/2007
Last updated
07/08/2007
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