Individual
MR. JOSE ORLEAN LOPEZ DE LA CRUZ III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3603 SOUTHRIDGE DR, APPARTMENT 2031, AUSTIN, TX 78704-7739
(786) 857-0656
Mailing address
3603 SOUTHRIDGE DR, APPARTMENT 2031, AUSTIN, TX 78704-7739
(786) 857-0656
Taxonomy
Speciality
Code
Description
License number
State
246ZC0007X
Surgical Assistant
Primary
16-245
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
711149917
—
TX
Enumeration date
05/13/2016
Last updated
05/13/2016
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