Individual
BERTHA IRIS LOPEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS,CCC-SLP
Contact information
Practice address
2007 CRESTWOOD PL, DENTON, TX 76209-2105
(940) 367-8101
(940) 239-9891
Mailing address
2007 CRESTWOOD PL, DENTON, TX 76209-2105
(940) 367-8101
(940) 239-9891
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
101334
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
20122650031700010857
COOK CHILDREN'S HEALTH PLAN/STAR
TX
05
—
201265003
—
TX
05
—
201265004
—
TX
01
—
LB00802
COOK CHILDREN'S HEALTH PLAN(CHIP)
TX
Enumeration date
05/05/2009
Last updated
06/27/2011
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