Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2084N0402X | Child Neurologist | 37283 | AL |
NPI | 1023376746 |
---|---|
Provider Name | Michael Alonzo Lopez |
First Address | Houston, TX 77030-3411 |
Second Address | Birmingham, AL 35233 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/05/2012 |
Last Update Date | 21/08/2018 |