Provider Demographics
NPI:1578160263
Name:LOPEZ, LUIS XAVIER (DC)
Entity Type:Individual
Prefix:DR
First Name:LUIS
Middle Name:XAVIER
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 1:300 S FIRESTONE ST APT 327
Mailing Address - Street 2:
Mailing Address - City:GASTONIA
Mailing Address - State:NC
Mailing Address - Zip Code:28052-4592
Mailing Address - Country:US
Mailing Address - Phone:787-619-5266
Mailing Address - Fax:
Practice Address - Street 1:210 E GROVER ST
Practice Address - Street 2:
Practice Address - City:SHELBY
Practice Address - State:NC
Practice Address - Zip Code:28150-3918
Practice Address - Country:US
Practice Address - Phone:704-480-1700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-06
Last Update Date:2020-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5231111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor