Provider Demographics
NPI:1558016857
Name:LOPEZ, JOSEPH LEE
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:LEE
Last Name:LOPEZ
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:716 S 9TH ST
Mailing Address - Street 2:
Mailing Address - City:HASKELL
Mailing Address - State:TX
Mailing Address - Zip Code:79521-7108
Mailing Address - Country:US
Mailing Address - Phone:940-781-4024
Mailing Address - Fax:
Practice Address - Street 1:7951 COLLIN MCKINNEY PKWY STE 200
Practice Address - Street 2:
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75070-7843
Practice Address - Country:US
Practice Address - Phone:469-294-9075
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-15
Last Update Date:2022-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX559111041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical