Provider Demographics
NPI:1326837824
Name:LOPEZ, ALEJANDRA
Entity type:Individual
Prefix:
First Name:ALEJANDRA
Middle Name:
Last Name:LOPEZ
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:179 SANTA LEAH
Mailing Address - Street 2:
Mailing Address - City:RIO GRANDE CITY
Mailing Address - State:TX
Mailing Address - Zip Code:78582-4429
Mailing Address - Country:US
Mailing Address - Phone:956-735-0017
Mailing Address - Fax:
Practice Address - Street 1:179 SANTA LEAH
Practice Address - Street 2:
Practice Address - City:RIO GRANDE CITY
Practice Address - State:TX
Practice Address - Zip Code:78582-4429
Practice Address - Country:US
Practice Address - Phone:956-735-0017
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-02
Last Update Date:2025-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX89193101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty