Doctor Name: | THOMAS LOPEZ |
NPI Number: | 1336541184 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | |
License Number: | 319419 |
Business Practice Address: | 4000 Edith Blvd Ne Albuquerque, NM - 871072222 |
Business Phone Number: | 5058414259 |
Business Fax Number: | 5058414314 |
Mailing Address: | Po Box 33922, SANTA FE |
State: | NM |
Postal Code: | 875943922 |
Phone Number: | 5053100097 |
Fax Number: | |
NPI Enumeration Date: | 09/24/2014 |
NPI Last Update Date: | 09/24/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | 319419 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NM |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |