Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207QS0010X | Family Doctor - Sports Medicine | 40756 | AZ |
Y | 207QS0010X | Family Doctor - Sports Medicine | N3844 | TX |
NPI | 1043494032 |
---|---|
Provider Name | Dr. Hector Uriel Lopez |
First Address | San Antonio, TX 78240-1679 |
Second Address | San Antonio, TX 78240-1679 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/12/2007 |
Last Update Date | 11/09/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
11977073 | CAQH (01) | |
8EF332 | BCBSTX (01) | TX |