Provider Demographics
NPI:1659657419
Name:LOPEZ, DARLENE D
Entity Type:Individual
Prefix:
First Name:DARLENE
Middle Name:D
Last Name:LOPEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14735 KENDALLBROOK DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77095-4555
Mailing Address - Country:US
Mailing Address - Phone:281-857-3343
Mailing Address - Fax:281-345-2113
Practice Address - Street 1:14735 KENDALLBROOK DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77095-4555
Practice Address - Country:US
Practice Address - Phone:281-857-3343
Practice Address - Fax:281-345-2113
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-25
Last Update Date:2013-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities