Provider Demographics
NPI:1073331070
Name:LOPEZ, SANJUANA A
Entity type:Individual
Prefix:
First Name:SANJUANA
Middle Name:A
Last Name:LOPEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:GABRIEL
Other - Middle Name:
Other - Last Name:CHAIRE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:704 S 11TH ST STE A
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78501-7926
Mailing Address - Country:US
Mailing Address - Phone:956-655-4067
Mailing Address - Fax:956-435-0256
Practice Address - Street 1:704 S 11TH ST STE A
Practice Address - Street 2:
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78501-7926
Practice Address - Country:US
Practice Address - Phone:956-655-4067
Practice Address - Fax:956-435-0256
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-30
Last Update Date:2024-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health