Provider Demographics
NPI:1275953382
Name:LOPEZ, SERENA MARIE (MSN, RN, FNP-BC)
Entity Type:Individual
Prefix:MRS
First Name:SERENA
Middle Name:MARIE
Last Name:LOPEZ
Suffix:
Gender:F
Credentials:MSN, RN, FNP-BC
Other - Prefix:
Other - First Name:SERENA
Other - Middle Name:MARIE
Other - Last Name:BAUTISTA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSN, RN, FNP-BC
Mailing Address - Street 1:8000 N SAM HOUSTON PKWY E
Mailing Address - Street 2:
Mailing Address - City:HUMBLE
Mailing Address - State:TX
Mailing Address - Zip Code:77396-2900
Mailing Address - Country:US
Mailing Address - Phone:281-454-0101
Mailing Address - Fax:
Practice Address - Street 1:8000 N SAM HOUSTON PKWY E
Practice Address - Street 2:
Practice Address - City:HUMBLE
Practice Address - State:TX
Practice Address - Zip Code:77396-2900
Practice Address - Country:US
Practice Address - Phone:281-454-0101
Practice Address - Fax:281-454-0107
Is Sole Proprietor?:No
Enumeration Date:2014-04-16
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP125204363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily