Provider Demographics
NPI:1265492201
Name:LOPEZ-COVAS, AGUSTIN J (MD)
Entity type:Individual
Prefix:DR
First Name:AGUSTIN
Middle Name:J
Last Name:LOPEZ-COVAS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 428
Mailing Address - Street 2:
Mailing Address - City:HUMACAO
Mailing Address - State:PR
Mailing Address - Zip Code:00792-0428
Mailing Address - Country:US
Mailing Address - Phone:787-852-0886
Mailing Address - Fax:787-852-0280
Practice Address - Street 1:334 CALLE FONT MARTELO
Practice Address - Street 2:
Practice Address - City:HUMACAO
Practice Address - State:PR
Practice Address - Zip Code:00791-3229
Practice Address - Country:US
Practice Address - Phone:787-852-0886
Practice Address - Fax:787-852-0280
Is Sole Proprietor?:No
Enumeration Date:2006-03-24
Last Update Date:2010-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR10627207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR10627OtherSTATE LICENCE