Individual
DR. OMAR JOSE PENA LOPEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
410 SOUTH BROADWAY, ELSA, TX 78543-0000
(956) 262-9805
(956) 262-9233
Mailing address
410 SOUTH BROADWAY, ELSA, TX 78543-0000
(956) 262-9805
(956) 262-9233
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
N1058
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201687501
—
TX
Enumeration date
03/28/2008
Last updated
02/10/2014
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