Provider Demographics
NPI:1477591493
Name:LOPEZ, ARSENIO GREGORIO III (MD)
Entity Type:Individual
Prefix:DR
First Name:ARSENIO
Middle Name:GREGORIO
Last Name:LOPEZ
Suffix:III
Gender:M
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:PO BOX 911230
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75391-1230
Mailing Address - Country:US
Mailing Address - Phone:972-997-8000
Mailing Address - Fax:972-437-9605
Practice Address - Street 1:7848 GATEWAY BLVD E
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79915-1815
Practice Address - Country:US
Practice Address - Phone:915-599-1313
Practice Address - Fax:915-599-1701
Is Sole Proprietor?:No
Enumeration Date:2006-06-03
Last Update Date:2008-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ9744207RX0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8R1494OtherBLUE CROSS OF TX
NM000L0353Medicaid
TX84591KMedicare PIN
TX8G3198Medicare PIN
TX80X788Medicare PIN
TX8R1494OtherBLUE CROSS OF TX