Individual
RUBY LOPEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4105 TERAVISTA CLUB DR, ROUND ROCK, TX 78665-1525
(512) 296-3411
Mailing address
1701 PRIMROSE TRL, ROUND ROCK, TX 78664-2628
(512) 296-3411
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2051731
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2051731
—
TX
Enumeration date
08/14/2018
Last updated
08/14/2018
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