1588931349 NPI number — DR. MARIA ALEJANDRA LOPEZ PHD, LPCS

Table of content: (NPI 1437203387)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1588931349 NPI number — DR. MARIA ALEJANDRA LOPEZ PHD, LPCS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
LOPEZ
Provider First Name:
MARIA
Provider Middle Name:
ALEJANDRA
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
PHD, LPCS
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1588931349
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/23/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4001 WALNUT HILL LN STE Y100
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
DALLAS
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
75229-6239
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
972-502-4063
Provider Business Mailing Address Fax Number:
214-932-7533

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2700 CLUB RIDGE DR APT 22
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LEWISVILLE
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
75067-3765
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
972-821-3086
Provider Business Practice Location Address Fax Number:
214-932-7533
Provider Enumeration Date:
11/22/2011

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: 101YP2500X , with the licence number:  68482 , 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)