Individual
MIRIAM SUGEI RIVERA LOPEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2020 BABCOCK RD STE 19, SAN ANTONIO, TX 78229-4437
(210) 761-9001
Mailing address
250 W LANCASTER AVE APT 1523, FORT WORTH, TX 76102-6361
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
1212542
TX
Other
Enumeration date
10/08/2025
Last updated
11/05/2025
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