Individual
DEYANIRA LOPEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
5326 E US HIGHWAY 83, SUITE A-5, RIO GRANDE CITY, TX 78582-9409
(956) 488-8820
(956) 488-8853
Mailing address
2821 MICHAEL ANGELO, SUITE 400, EDINBURG, TX 78539-1404
(956) 683-7900
(956) 683-9910
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA03193
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PA03193
STATE LICENSE NUMBER
TX
Enumeration date
03/22/2007
Last updated
12/02/2010
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