Provider Demographics
NPI:1760522098
Name:JF LOPEZ DDS, MD, RPH, PA
Entity Type:Organization
Organization Name:JF LOPEZ DDS, MD, RPH, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:F
Authorized Official - Last Name:LOPEZ
Authorized Official - Suffix:
Authorized Official - Credentials:DDS, MD
Authorized Official - Phone:713-622-8607
Mailing Address - Street 1:1770 SAINT JAMES PL
Mailing Address - Street 2:SUITE 512
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77056-3471
Mailing Address - Country:US
Mailing Address - Phone:713-622-8607
Mailing Address - Fax:
Practice Address - Street 1:1770 SAINT JAMES PL
Practice Address - Street 2:SUITE 512
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77056-3471
Practice Address - Country:US
Practice Address - Phone:713-622-8607
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-07
Last Update Date:2009-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX198571223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Single Specialty