Provider Demographics
NPI:1942865597
Name:LOPEZ, MONICA
Entity Type:Individual
Prefix:
First Name:MONICA
Middle Name:
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 1:6565 SPENCER HWY APT 2006
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:TX
Mailing Address - Zip Code:77505-1763
Mailing Address - Country:US
Mailing Address - Phone:832-544-4048
Mailing Address - Fax:
Practice Address - Street 1:6565 SPENCER HWY APT 2006
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:TX
Practice Address - Zip Code:77505-1763
Practice Address - Country:US
Practice Address - Phone:832-544-4048
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-08
Last Update Date:2019-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX965607163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse