Individual
DALLAS JACOB LOPEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
615A GALE ST, LAREDO, TX 78041-5955
(956) 712-9988
Mailing address
2903 MUSSER ST, LAREDO, TX 78043-2525
(956) 740-7731
Taxonomy
Speciality
Code
Description
License number
State
2355S0801X
Speech-Language Assistant
Primary
39767
TX
Other
Enumeration date
09/01/2016
Last updated
08/15/2018
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