Provider Demographics
NPI:1508395260
Name:LOPEZ VASQUEZ, DASHA VALERIA (MD)
Entity Type:Individual
Prefix:
First Name:DASHA
Middle Name:VALERIA
Last Name:LOPEZ VASQUEZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:7373 PERKINS RD
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70808-4373
Mailing Address - Country:US
Mailing Address - Phone:225-246-9790
Mailing Address - Fax:225-246-9160
Practice Address - Street 1:7373 PERKINS RD
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70808-4373
Practice Address - Country:US
Practice Address - Phone:225-246-9790
Practice Address - Fax:225-246-9160
Is Sole Proprietor?:No
Enumeration Date:2017-06-07
Last Update Date:2022-07-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
LA323731207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology