Provider Demographics
NPI:1356462998
Name:ALEJANDRO LOPEZ JR, M.D.,P.A.
Entity Type:Organization
Organization Name:ALEJANDRO LOPEZ JR, M.D.,P.A.
Other - Org Name:SOUTH TEXAS FAMILY MEDICAL CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:ALEJANDRO
Authorized Official - Middle Name:
Authorized Official - Last Name:LOPEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:361-664-8811
Mailing Address - Street 1:201 MARIPOSA
Mailing Address - Street 2:
Mailing Address - City:ALICE
Mailing Address - State:TX
Mailing Address - Zip Code:78332-4177
Mailing Address - Country:US
Mailing Address - Phone:361-664-8811
Mailing Address - Fax:361-664-8992
Practice Address - Street 1:201 MARIPOSA
Practice Address - Street 2:
Practice Address - City:ALICE
Practice Address - State:TX
Practice Address - Zip Code:78332-4177
Practice Address - Country:US
Practice Address - Phone:361-664-8811
Practice Address - Fax:361-664-8992
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-02
Last Update Date:2008-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX079902502Medicaid
TX00109NOtherBCBS
TX00109NOtherBCBS
TX00109NMedicare PIN