Individual
ANTONIO J LOPEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
3149 AMBASSADOR CAFFERY PKWY, LAFAYETTE, LA 70506-7209
(377) 706-3145
Mailing address
2495 SHREVEPORT HWY, PINEVILLE, LA 71360-4044
(337) 706-3415
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA.200674
LA
363AM0700X
Medical Physician Assistant
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Other
Enumeration date
09/12/2013
Last updated
04/16/2024
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