Individual
CHRISTY JEAN LOPEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
701 TILLERY ST STE 12, AUSTIN, TX 78702-3751
(877) 711-6559
Mailing address
701 TILLERY ST STE 12, AUSTIN, TX 78702-3751
(877) 711-6559
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
06021561
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3732725
FMCSA
TX
Enumeration date
11/08/2021
Last updated
11/08/2021
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