Individual
TANIA LOPEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNM
Contact information
Practice address
855 MONTGOMERY ST, FORT WORTH, TX 76107-2553
(817) 735-2363
(817) 702-6561
Mailing address
855 MONTGOMERY ST, FORT WORTH, TX 76107-2553
(817) 735-2363
Taxonomy
Speciality
Code
Description
License number
State
367A00000X
Advanced Practice Midwife
Primary
597529
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
177150301
—
TX
01
—
8N9742
BCBS
TX
Enumeration date
07/31/2006
Last updated
06/24/2020
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