Individual provider · Type 1 NPI

Shastidy Pauline Lopez, CCSS

Military Health Care Provider · Tijeras, NM

NPI number 1962273854 Active

Practice location

1 Camino Oro Ct
Tijeras, NM 87059-7924

Call (706) 593-8731 Map

Fax (706) 593-8732

Mailing address

PO Box 45681
Rio Rancho, NM 87174-5681

Specialties and licenses

TaxonomyCodeLicense
Military Health Care Provider Primary 171000000XNone listed

Military Health Care Provider: Active duty military health care providers not otherwise classified who need to be separately identified for operational, clinical, or administrative processes.

13 other providers at this address

About NPI 1962273854

Shastidy Pauline Lopez, CCSS's National Provider Identifier is 1962273854, issued on Jan 10, 2024. The primary taxonomy on file is Military Health Care Provider (171000000X), and the practice location is in Tijeras, NM. The record was last updated on Sep 26, 2024.