Provider Demographics
NPI:1619194578
Name:LOPEZ, TERESA MARGARITA (PT)
Entity Type:Individual
Prefix:MRS
First Name:TERESA
Middle Name:MARGARITA
Last Name:LOPEZ
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3912 BELLA VISTA LOOP
Mailing Address - Street 2:
Mailing Address - City:HARKER HEIGHTS
Mailing Address - State:TX
Mailing Address - Zip Code:76548-8719
Mailing Address - Country:US
Mailing Address - Phone:254-291-7929
Mailing Address - Fax:254-698-7009
Practice Address - Street 1:806 E AVENUE D
Practice Address - Street 2:SUITE D
Practice Address - City:COPPERAS COVE
Practice Address - State:TX
Practice Address - Zip Code:76522-2284
Practice Address - Country:US
Practice Address - Phone:254-518-1380
Practice Address - Fax:254-518-1385
Is Sole Proprietor?:No
Enumeration Date:2007-04-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1075513225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist