| Salvador Lopez Jr Phd Pc | |
|
7201 Broadway St Suite 218 San Antonio TX 78209-3773 | |
| (210) 413-9779 | |
| (210) 239-6868 |
| Full Name | Salvador Lopez Jr Phd Pc |
|---|---|
| Speciality | Psychologist |
| Location | 7201 Broadway St, San Antonio, Texas |
| Authorized Official Name and Position | Salvador Lopez (DIRECTOR) |
| Authorized Official Contact | 2104139779 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Salvador Lopez Jr Phd Pc 7201 Broadway St Suite 218 San Antonio TX 78209-3773 Ph: (210) 413-9779 | Salvador Lopez Jr Phd Pc 7201 Broadway St Suite 218 San Antonio TX 78209-3773 Ph: (210) 413-9779 |
| NPI Number | 1497199913 |
|---|---|
| Provider Enumeration Date | 04/26/2013 |
| Last Update Date | 07/28/2015 |
| Medicare PECOS PAC ID | 3375854433 |
|---|---|
| Medicare Enrollment ID | O20150617000316 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1497199913 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | 22593 (Texas) | Primary |
| Provider Name | Salvador Lopez |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1902975444 PECOS PAC ID: 6901708189 Enrollment ID: I20040127000526 |
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