Provider Demographics
NPI:1053383810
Name:LOPEZ, JOSE A (MD)
Entity type:Individual
Prefix:MR
First Name:JOSE
Middle Name:A
Last Name:LOPEZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:PO BOX 5958
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78502-5958
Mailing Address - Country:US
Mailing Address - Phone:956-362-8677
Mailing Address - Fax:956-362-7253
Practice Address - Street 1:5501 S MCCOLL RD
Practice Address - Street 2:
Practice Address - City:EDINBURG
Practice Address - State:TX
Practice Address - Zip Code:78539-5503
Practice Address - Country:US
Practice Address - Phone:956-362-8677
Practice Address - Fax:956-362-7253
Is Sole Proprietor?:No
Enumeration Date:2006-02-06
Last Update Date:2023-04-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXL9786207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX174204102Medicaid
TX174204109Medicaid
TX8U5313OtherBLUE CROSS BLUE SHIELD
TXH08MM43001OtherBCBS
TX174204111Medicaid
TXP00263584OtherRAILROAD MEDICARE