Provider Demographics
NPI:1427463264
Name:LOPEZ, CARLOS O (PHARMD)
Entity type:Individual
Prefix:DR
First Name:CARLOS
Middle Name:O
Last Name:LOPEZ
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5009 S MCCOLL RD STE A
Mailing Address - Street 2:
Mailing Address - City:EDINBURG
Mailing Address - State:TX
Mailing Address - Zip Code:78539-8014
Mailing Address - Country:US
Mailing Address - Phone:956-467-0264
Mailing Address - Fax:956-688-8967
Practice Address - Street 1:5009 S MCCOLL RD STE A
Practice Address - Street 2:
Practice Address - City:EDINBURG
Practice Address - State:TX
Practice Address - Zip Code:78539-8014
Practice Address - Country:US
Practice Address - Phone:956-467-0264
Practice Address - Fax:956-688-8967
Is Sole Proprietor?:No
Enumeration Date:2014-06-30
Last Update Date:2014-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX42126183500000X
AL17287183500000X
AZS016554183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist