Provider Demographics
NPI:1689193377
Name:LOPEZ, GABRIELA (FNP-BC)
Entity type:Individual
Prefix:MS
First Name:GABRIELA
Middle Name:
Last Name:LOPEZ
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5316 E PAISANO DR STE B
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79905-2945
Mailing Address - Country:US
Mailing Address - Phone:915-234-7778
Mailing Address - Fax:
Practice Address - Street 1:1700 N OREGON ST STE 780
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79902-3557
Practice Address - Country:US
Practice Address - Phone:915-533-8797
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-09-13
Last Update Date:2019-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP135113363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily