Individual provider · Type 1 NPI
Nicole Teretha Lopez, PA
Medical Physician Assistant · Jbsa Fort Sam Houston, TX
NPI number
1669628111
Active
Practice location
3551 Roger Brooke Dr
Jbsa Fort Sam Houston, TX 78234-4504
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Medical Physician Assistant Primary | 363AM0700X | PA06960 (TX) |
Medical Physician Assistant: Definition to come...
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About NPI 1669628111
Nicole Teretha Lopez, PA's National Provider Identifier is 1669628111, issued on Aug 15, 2008. The primary taxonomy on file is Medical Physician Assistant (363AM0700X), and the practice location is in Jbsa Fort Sam Houston, TX. The record was last updated on Apr 18, 2018.