Provider Demographics
NPI:1699276063
Name:LOPEZ, ANA LUCIA (LVN)
Entity type:Individual
Prefix:
First Name:ANA
Middle Name:LUCIA
Last Name:LOPEZ
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:324 BAYO DR
Mailing Address - Street 2:
Mailing Address - City:EAGLE PASS
Mailing Address - State:TX
Mailing Address - Zip Code:78852-7426
Mailing Address - Country:US
Mailing Address - Phone:830-513-2711
Mailing Address - Fax:
Practice Address - Street 1:13601 PRESTON RD STE 210W
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75240-4986
Practice Address - Country:US
Practice Address - Phone:855-452-6435
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-21
Last Update Date:2018-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX314609164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse