Individual
JORGE LOPEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
4902 W HIGHWAY 83, STE 2, ROMA, TX 78584-7858
(956) 519-3227
Mailing address
258 EAST LAS PALMAS, LA GRULLA, TX 78548
(956) 437-7911
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
760304
TX
Other
Enumeration date
10/21/2019
Last updated
10/21/2019
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