Provider Demographics
NPI:1487045977
Name:LOPEZ, MICHAEL A (DC)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:A
Last Name:LOPEZ
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5050 FM 423
Mailing Address - Street 2:APT 2314
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75034-7133
Mailing Address - Country:US
Mailing Address - Phone:469-237-4637
Mailing Address - Fax:
Practice Address - Street 1:8880 STATE HIGHWAY 121
Practice Address - Street 2:SUITE 152
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75070-3166
Practice Address - Country:US
Practice Address - Phone:469-237-4637
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-02-05
Last Update Date:2015-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA33134111N00000X
TX12895111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor