Provider Demographics
NPI:1639842628
Name:LOPEZ, JAVIER (MED)
Entity Type:Individual
Prefix:
First Name:JAVIER
Middle Name:
Last Name:LOPEZ
Suffix:
Gender:M
Credentials:MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:US ARMY MEDICAL ACTIVITY-BAVARIA UNIT 28038
Mailing Address - Street 2:ATTN: MCEU-BAV-CRE
Mailing Address - City:STUTTGART
Mailing Address - State:GERMANY
Mailing Address - Zip Code:APO AE 09112
Mailing Address - Country:DE
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:US ARMY MEDICAL ACTIVITY-BAVARIA UNIT 28038
Practice Address - Street 2:ATTN: MCEU-BAV-CRE
Practice Address - City:STUTTGART
Practice Address - State:GERMANY
Practice Address - Zip Code:APO AE 09112
Practice Address - Country:DE
Practice Address - Phone:490-637-1946
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-27
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX84263101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional