Individual
JENNIFER KNICKERBOCKER LOPEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHYSICIAN ASSISTANT
Contact information
Practice address
5702 SAINTSBURY DR APT 123, THE COLONY, TX 75056-5488
(316) 558-2341
Mailing address
5702 SAINTSBURY DR APT 123, THE COLONY, TX 75056-5488
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
06/18/2019
Last updated
07/12/2023
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