Individual
ANN MARGUERITE LOPEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
100 HOSPITAL AVE, DU BOIS, PA 15801
(814) 371-2200
Mailing address
620 SAN GABRIEL OVERLOOK E, GEORGETOWN, TX 78628-7638
(512) 630-6333
(817) 735-1880
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
S5419
TX
207Q00000X
Family Medicine Physician
OT018098
PA
207Q00000X
Family Medicine Physician
S5419
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
103520894
—
PA
05
—
1750657983
—
TX
Enumeration date
04/01/2012
Last updated
12/20/2023
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