Most Relevant Information
Provider Data
| NPI Number: | 1003447350 |
| Provider Name: | ALEXIS LOPEZ |
| Entity Type: | Individual |
| Taxonomy Code: | 390200000X |
| Specialty: | Student in an Organized Health Care Education/Training Program |
| License Number: |
Most Important Dates
| Enumeration Date: | 01/27/2020 |
| Last Updated: | 01/27/2020 |
Provider Practice Location
405 QUEENSWOOD TRL
VICTORIA
TX
779012548
Practice Location Phone/Fax
| Phone: | 3615504234 |
| Fax: |
Provider Mailing Location
405 QUEENSWOOD TRL
VICTORIA
TX
779012548
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |