Provider Demographics
NPI:1174951859
Name:LOPEZ-CARDENAS, MANUEL S (LSA)
Entity type:Individual
Prefix:MR
First Name:MANUEL
Middle Name:S
Last Name:LOPEZ-CARDENAS
Suffix:
Gender:M
Credentials:LSA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:330 RAYFORD RD STE 238
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77386-1980
Mailing Address - Country:US
Mailing Address - Phone:214-227-2457
Mailing Address - Fax:214-764-0880
Practice Address - Street 1:1 SUGAR CREEK BLVD
Practice Address - Street 2:STE 618
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77478
Practice Address - Country:US
Practice Address - Phone:832-655-4141
Practice Address - Fax:713-457-5188
Is Sole Proprietor?:Yes
Enumeration Date:2013-10-16
Last Update Date:2023-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXSA00632246ZC0007X, 246ZC0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8SY137OtherUS MSO
TX8SY056OtherBLUE STAR SURGICAL ASSISTANTS
TX8SY029OtherXCITE SURGICAL
TX8SK413OtherUNIVERSAL SURGICAL ASSISTANTS