Individual
MAYLENE LOPEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
3600 GASTON AVE, SUITE 550, DALLAS, TX 75246-1800
(214) 712-2074
(214) 712-2444
Mailing address
2901 RIVIERA DR, GARLAND, TX 75040-4281
(903) 746-1032
(214) 712-2444
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
735525
TX
Other
Enumeration date
08/01/2013
Last updated
04/05/2022
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