Provider Demographics
NPI:1093045122
Name:LOPEZ, MICHAEL DAN (DC)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:DAN
Last Name:LOPEZ
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 1210
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75034
Mailing Address - Country:US
Mailing Address - Phone:817-727-4690
Mailing Address - Fax:817-727-4695
Practice Address - Street 1:2655 E. BELTLINE RD.
Practice Address - Street 2:
Practice Address - City:CARROLLTON
Practice Address - State:TX
Practice Address - Zip Code:75006
Practice Address - Country:US
Practice Address - Phone:972-417-9966
Practice Address - Fax:972-417-9732
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-12
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX11291111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitation