Provider Demographics
NPI:1225828239
Name:LOPEZ-MONTEMAYOR, ITALY (IBCLC)
Entity type:Individual
Prefix:
First Name:ITALY
Middle Name:
Last Name:LOPEZ-MONTEMAYOR
Suffix:
Gender:F
Credentials:IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3604 N COGNAC DR
Mailing Address - Street 2:
Mailing Address - City:PHARR
Mailing Address - State:TX
Mailing Address - Zip Code:78577-7562
Mailing Address - Country:US
Mailing Address - Phone:956-638-2958
Mailing Address - Fax:956-638-2958
Practice Address - Street 1:3604 N COGNAC DR
Practice Address - Street 2:
Practice Address - City:PHARR
Practice Address - State:TX
Practice Address - Zip Code:78577-7562
Practice Address - Country:US
Practice Address - Phone:956-638-2958
Practice Address - Fax:956-638-2958
Is Sole Proprietor?:No
Enumeration Date:2025-05-12
Last Update Date:2025-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL-315638174N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RN