Provider Demographics
NPI:1437336864
Name:LOPEZ, CHERYL PAN (DO)
Entity type:Individual
Prefix:DR
First Name:CHERYL
Middle Name:PAN
Last Name:LOPEZ
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:3880 PARKWOOD BLVD
Mailing Address - Street 2:SUITE 303
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75034-1928
Mailing Address - Country:US
Mailing Address - Phone:214-618-7952
Mailing Address - Fax:214-618-7991
Practice Address - Street 1:3880 PARKWOOD BLVD
Practice Address - Street 2:SUITE 303
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75034-1928
Practice Address - Country:US
Practice Address - Phone:214-618-7952
Practice Address - Fax:214-618-7991
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-28
Last Update Date:2008-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK0903207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
104282OtherHEALTH PARTNERS
7240640007OtherCIGNA
21149563445OtherBEECHSTREET
2559446OtherHEALTHMARKET
5018550OtherAETNA
TX82610FOtherBCBSTX
1015218OtherAETNA
527359OtherDESERET
TXP082610FDMedicaid
1076462OtherFIRST HEALTH
82610FMedicare PIN
TX82610FOtherBCBSTX
TXP082610FDMedicaid