Provider Demographics
NPI:1942210968
Name:LOPEZ, CYNTHIA (MD)
Entity Type:Individual
Prefix:DR
First Name:CYNTHIA
Middle Name:
Last Name:LOPEZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1314 E SONTERRA
Mailing Address - Street 2:SUITE 5102
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78258-4289
Mailing Address - Country:US
Mailing Address - Phone:210-490-8888
Mailing Address - Fax:210-496-6865
Practice Address - Street 1:1314 E SONTERRA BLVD
Practice Address - Street 2:SUITE 5102
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78258-4278
Practice Address - Country:US
Practice Address - Phone:210-490-8888
Practice Address - Fax:210-496-6865
Is Sole Proprietor?:No
Enumeration Date:2006-08-09
Last Update Date:2012-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK5340208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX143682601Medicaid
TXH29271OtherUPIN
TX86247KMedicare ID - Type UnspecifiedMEDICARE