Provider Demographics
NPI:1275801888
Name:LOPEZ, ROCHELLE (MD)
Entity Type:Individual
Prefix:DR
First Name:ROCHELLE
Middle Name:
Last Name:LOPEZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1796 OLD SAN ANTONIO RD
Mailing Address - Street 2:
Mailing Address - City:FREDERICKSBURG
Mailing Address - State:TX
Mailing Address - Zip Code:78624-6116
Mailing Address - Country:US
Mailing Address - Phone:512-680-1076
Mailing Address - Fax:830-997-1129
Practice Address - Street 1:1796 OLD SAN ANTONIO RD
Practice Address - Street 2:
Practice Address - City:FREDERICKSBURG
Practice Address - State:TX
Practice Address - Zip Code:78624-6116
Practice Address - Country:US
Practice Address - Phone:512-680-1076
Practice Address - Fax:830-997-1129
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-09
Last Update Date:2011-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF5279207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology