Individual
GUILLERMO ANTONIO LOPEZ-GONZALEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
701 W 5TH ST, ODESSA, TX 79763-4206
(432) 703-5245
Mailing address
28112 HERITAGE TRL, FAIR OAKS RANCH, TX 78015-6526
(210) 589-2547
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
T4204
TX
207Q00000X
Family Medicine Physician
T4204
TX
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/25/2014
Last updated
02/02/2023
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