Organization
LOPEZ ANESTHESIA PA
Active
Organization
LOPEZ ANESTHESIA PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. VICTOR LOPEZ MD (OWNER)
(956) 763-4682
Entity
Organization
Contact information
Practice address
10700 MCPHERSON AVE, LAREDO, TX 78045-6268
(956) 763-4682
Mailing address
P O BOX 678690, DALLAS, TX 75267-8690
(972) 758-3598
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
—
367500000X
Certified Registered Nurse Anesthetist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0048MG
BCBS
TX
01
—
00C62S
BCBS
TX
05
—
172296901
—
TX
05
—
172296902
—
TX
01
—
DR6387
RAILROAD
TX
Enumeration date
06/29/2006
Last updated
12/27/2011
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