Most Relevant Information
Provider Data
| NPI Number: | 1003670571 |
| Provider Name: | BLANCA P BAUTISTA LOPEZ |
| Entity Type: | Individual |
| Taxonomy Code: | 106S00000X |
| Specialty: | Behavior Technician |
| License Number: |
Most Important Dates
| Enumeration Date: | 02/06/2024 |
| Last Updated: | 05/09/2024 |
Provider Practice Location
255 LEBANON RD
STE 212
FRISCO
TX
750363404
Practice Location Phone/Fax
| Phone: | 8557827822 |
| Fax: |
Provider Mailing Location
5522 LONE STAR PKWY STE 101
SAN ANTONIO
TX
782536719
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |