Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | P7151 | TX |
Y | 2080P0207X | Pediatric Hematology-Oncologist | P7151 | TX |
NPI | 1215242383 |
---|---|
Provider Name | Dr. Erika A Lopez Bertiery |
First Address | Dallas, TX 75391-1230 |
Second Address | Dallas, TX 75230-6899 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/08/2010 |
Last Update Date | 04/12/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
359487103 | (05) | TX |