Provider Demographics
NPI:1841792223
Name:LOPEZ, DANNY ANTONY
Entity Type:Individual
Prefix:
First Name:DANNY
Middle Name:ANTONY
Last Name:LOPEZ
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1255 W FREY ST APT 206
Mailing Address - Street 2:
Mailing Address - City:STEPHENVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:76401-2907
Mailing Address - Country:US
Mailing Address - Phone:830-410-9538
Mailing Address - Fax:
Practice Address - Street 1:1255 W FREY ST APT 206
Practice Address - Street 2:
Practice Address - City:STEPHENVILLE
Practice Address - State:TX
Practice Address - Zip Code:76401-2907
Practice Address - Country:US
Practice Address - Phone:830-410-9538
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-01
Last Update Date:2018-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer