Individual
THOMAS LOPEZ I
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4000 EDITH BLVD NE, ALBUQUERQUE, NM 87107-2222
(505) 841-4259
(505) 841-4314
Mailing address
PO BOX 33922, SANTA FE, NM 87594-3922
(505) 310-0097
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
319419
NM
Other
Enumeration date
09/24/2014
Last updated
09/24/2014
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