Provider Demographics
NPI:1528352960
Name:LOPEZ, WENDY (FNP)
Entity type:Individual
Prefix:
First Name:WENDY
Middle Name:
Last Name:LOPEZ
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:902 FROSTWOOD DR STE 179
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77024-2402
Mailing Address - Country:US
Mailing Address - Phone:713-255-0400
Mailing Address - Fax:
Practice Address - Street 1:902 FROSTWOOD DR STE 179
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77024-2402
Practice Address - Country:US
Practice Address - Phone:713-255-0400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-06-02
Last Update Date:2023-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX713474363L00000X
TXAP119654363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner