Individual
MR. VICTOR ANTONIO LOPEZ III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
IDMT
Contact information
Practice address
WEST 9TH ST 619, IRAAN, TX 79744
(432) 402-0471
Mailing address
PO BOX 664, IRAAN, TX 79744
(432) 302-0471
Taxonomy
Speciality
Code
Description
License number
State
1710I1003X
Independent Duty Medical Technicians
Primary
—
—
Other
Enumeration date
08/16/2021
Last updated
08/16/2021
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