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Individual

ADRIEL LOPEZ

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
O.D.

Contact information

Practice address
4436 PACK SADDLE PASS, SUITE B, AUSTIN, TX 78745-1624
(512) 444-7200
(512) 444-7489
Mailing address
4436 PACK SADDLE PASS, SUITE B, AUSTIN, TX 78745-1624
(512) 444-7200
(512) 444-7489

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
1238
VA
152W00000X
Optometrist
Primary
3360TG
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
112432303
TX
Enumeration date
07/06/2006
Last updated
11/26/2014
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