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Individual

SALVADOR LOPEZ JR.

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PHD

Contact information

Practice address
7201 BROADWAY ST, SUITE 218, SAN ANTONIO, TX 78209-3743
(210) 413-9779
(210) 239-6868
Mailing address
7201 BROADWAY ST, SUITE 218, SAN ANTONIO, TX 78209-3743
(210) 413-9779
(210) 239-6868

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
22593
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
00N83R
BCBS
TX
05
035101701
TX
01
680015367
MEDICARE RAILROAD
TX
Enumeration date
11/07/2006
Last updated
07/28/2015
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