Jose Carlos Lopez, ATP
Technician, Other in Tyler, TX. Individual provider (NPI-1).
NPI number1669908018
StatusActive
Last updated in NPPESMay 4, 2017
Details
- NPI
- 1669908018
- Entity type
- Individual (NPI-1)
- Name
- Jose Carlos Lopez
- Credential
- ATP
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- May 4, 2017
- Last updated
- May 4, 2017
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 247200000X | Technician, Other | ATP88042 | TX | Yes |
Practice location
12406 State Highway 155 STyler, TX 75703-6446
Phone 903-592-6760
Mailing address
12406 Sh 155 SouthTyler, TX 75703
Phone 903-592-6760
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