Individual
CHARLES MICHAEL LOPEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
15111 PIONEER WAY, SAN ANTONIO, TX 78245-9661
(210) 459-7724
Mailing address
15111 PIONEER WAY, SAN ANTONIO, TX 78245-9661
(210) 459-7724
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NA
NA
TX
Enumeration date
06/22/2022
Last updated
06/22/2022
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