Provider Demographics
NPI:1700348638
Name:LOPEZ, ALEJANDRO EFRAIN JR (MA, LPC)
Entity Type:Individual
Prefix:
First Name:ALEJANDRO
Middle Name:EFRAIN
Last Name:LOPEZ
Suffix:JR
Gender:M
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8310 TIMBER BOUGH ST
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78250-4436
Mailing Address - Country:US
Mailing Address - Phone:210-724-7880
Mailing Address - Fax:
Practice Address - Street 1:8310 TIMBER BOUGH ST
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78250-4436
Practice Address - Country:US
Practice Address - Phone:210-724-7880
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-01
Last Update Date:2019-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX77229101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional