Provider Demographics
NPI:1467114843
Name:LOPEZ, RAQUEL (MSN, APRN, FNP-C)
Entity Type:Individual
Prefix:
First Name:RAQUEL
Middle Name:
Last Name:LOPEZ
Suffix:
Gender:F
Credentials:MSN, APRN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2448 QUAIL TRL
Mailing Address - Street 2:
Mailing Address - City:BROWNSVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78520-9019
Mailing Address - Country:US
Mailing Address - Phone:956-295-4004
Mailing Address - Fax:
Practice Address - Street 1:191 E PRICE RD
Practice Address - Street 2:
Practice Address - City:BROWNSVILLE
Practice Address - State:TX
Practice Address - Zip Code:78521-3527
Practice Address - Country:US
Practice Address - Phone:956-548-7400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-12
Last Update Date:2022-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1056850363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily