Provider Demographics
NPI:1285067967
Name:LOPEZ, CHRISTINA ANN (MS, RD, LD, CNSC)
Entity type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:ANN
Last Name:LOPEZ
Suffix:
Gender:F
Credentials:MS, RD, LD, CNSC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23130 AIREDALE LN
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78260-6665
Mailing Address - Country:US
Mailing Address - Phone:210-385-0886
Mailing Address - Fax:
Practice Address - Street 1:23130 AIREDALE LN
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78260-6665
Practice Address - Country:US
Practice Address - Phone:210-385-0886
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-16
Last Update Date:2013-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDT80974133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered