Individual
JOSE DANIEL LOPEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CSFA
Contact information
Practice address
7919 ABBOTTS POINTE, SAN ANTONIO, TX 78254
(210) 204-7728
Mailing address
7919 ABBOTTS POINTE, SAN ANTONIO, TX 78254-5478
(210) 204-7728
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
14-9444
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
13507539
CAQH
TX
01
—
149444
NBSTSA BOARD CERTIFICATION
—
Enumeration date
01/26/2015
Last updated
11/09/2018
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