Provider Demographics
NPI:1952370934
Name:LOPEZ, FRANK W (MD)
Entity Type:Individual
Prefix:
First Name:FRANK
Middle Name:W
Last Name:LOPEZ
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:4845 LAKE ST
Mailing Address - Street 2:# 214
Mailing Address - City:LAKE CHARLES
Mailing Address - State:LA
Mailing Address - Zip Code:70605-6009
Mailing Address - Country:US
Mailing Address - Phone:337-475-1028
Mailing Address - Fax:337-475-2814
Practice Address - Street 1:3505 5TH AVE
Practice Address - Street 2:SUITE A-1
Practice Address - City:LAKE CHARLES
Practice Address - State:LA
Practice Address - Zip Code:70607-2156
Practice Address - Country:US
Practice Address - Phone:337-475-1028
Practice Address - Fax:337-475-2814
Is Sole Proprietor?:No
Enumeration Date:2006-03-14
Last Update Date:2018-03-27
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Provider Licenses
StateLicense IDTaxonomies
LA09855R208100000X, 2081P2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
No2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1973548Medicaid
LAC29819Medicare UPIN
LA1973548Medicaid