Individual
ERIC J LOPEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
605 S CONROE MEDICAL DR, STE 100, CONROE, TX 77304-4722
(936) 523-5236
Mailing address
605 SOUTH CONROE MEDICAL DRIVE, STE 100, CONROE, TX 77304-2928
(936) 523-5236
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PA735
NV
363AM0700X
Medical Physician Assistant
Primary
PA05322
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100505898
—
NV
Enumeration date
08/19/2005
Last updated
05/28/2013
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