Provider Demographics
NPI:1265172647
Name:LOPEZ, VICTORIA (APRN)
Entity type:Individual
Prefix:
First Name:VICTORIA
Middle Name:
Last Name:LOPEZ
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9202 LOBELIA MANOR DR
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77379-3746
Mailing Address - Country:US
Mailing Address - Phone:281-814-5340
Mailing Address - Fax:
Practice Address - Street 1:13154 COIT RD
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75240-5773
Practice Address - Country:US
Practice Address - Phone:469-726-2287
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-31
Last Update Date:2025-01-17
Deactivation Date:2022-09-19
Deactivation Code:
Reactivation Date:2024-05-16
Provider Licenses
StateLicense IDTaxonomies
TX880073163WM0705X
TX1141080363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Single Specialty
No163WM0705XNursing Service ProvidersRegistered NurseMedical-SurgicalGroup - Single Specialty