Provider Demographics
NPI:1194571893
Name:LOPEZ-SANCHEZ, JOSHUA ALEXANDER
Entity type:Individual
Prefix:
First Name:JOSHUA
Middle Name:ALEXANDER
Last Name:LOPEZ-SANCHEZ
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24200 W INTERSTATE 10
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78257-1145
Mailing Address - Country:US
Mailing Address - Phone:210-816-9994
Mailing Address - Fax:
Practice Address - Street 1:24200 W INTERSTATE 10
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78257-1145
Practice Address - Country:US
Practice Address - Phone:210-816-9932
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-24
Last Update Date:2024-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician