Individual
DR. JOSE A LOPEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
204 W SCHUBERT ST, FREDERICKSBURG, TX 78624-3847
(830) 990-0255
(830) 997-7569
Mailing address
204 W SCHUBERT ST, FREDERICKSBURG, TX 78624-3847
(830) 990-0255
(830) 997-7569
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
G6963
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
125442702
—
TX
01
—
4547005
AETNA PPO
TX
01
—
83Z202
BLUECROSS/BLUE SHIELD TX.
TX
01
—
924703
AETNA HMO
TX
Enumeration date
07/31/2006
Last updated
06/20/2008
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