Provider Demographics
NPI:1093312993
Name:LOPEZ, ULA SCOTT
Entity Type:Individual
Prefix:
First Name:ULA
Middle Name:SCOTT
Last Name:LOPEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 52
Mailing Address - Street 2:
Mailing Address - City:WINNSBORO
Mailing Address - State:LA
Mailing Address - Zip Code:71295-0052
Mailing Address - Country:US
Mailing Address - Phone:318-516-9784
Mailing Address - Fax:
Practice Address - Street 1:1002 BOSWORTH ST
Practice Address - Street 2:
Practice Address - City:WINNSBORO
Practice Address - State:LA
Practice Address - Zip Code:71295-2504
Practice Address - Country:US
Practice Address - Phone:318-516-9784
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-04
Last Update Date:2020-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care