Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207PP0204X | Pediatric Emergency Physician | L1114 | TX |
NPI | 1356313126 |
---|---|
Provider Name | Dr. Esteban R Lopez |
First Address | San Antonio, TX 78258-3913 |
Second Address | San Antonio, TX 78258-3913 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/02/2006 |
Last Update Date | 08/07/2007 |