1437668787 NPI number — ASHLEY JUANITA LOPEZ CPNP

Table of content: ASHLEY JUANITA LOPEZ CPNP (NPI 1437668787)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1437668787 NPI number — ASHLEY JUANITA LOPEZ CPNP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
LOPEZ
Provider First Name:
ASHLEY
Provider Middle Name:
JUANITA
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
CPNP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
TREVINO
Provider Other First Name:
ASHLEY
Provider Other Middle Name:
JUANITA
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1437668787
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/02/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3750 COMMERCIAL AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SAN ANTONIO
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
78221-3117
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
210-922-7000
Provider Business Mailing Address Fax Number:
210-646-9606

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
17323 IH 35 N STE 113
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SCHERTZ
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78154-1278
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
210-922-7000
Provider Business Practice Location Address Fax Number:
210-646-9606
Provider Enumeration Date:
09/28/2017

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 208000000X , with the licence number:  AP135171 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)