Provider Demographics
NPI:1437668787
Name:LOPEZ, ASHLEY JUANITA (CPNP)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:JUANITA
Last Name:LOPEZ
Suffix:
Gender:F
Credentials:CPNP
Other - Prefix:
Other - First Name:ASHLEY
Other - Middle Name:JUANITA
Other - Last Name:TREVINO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3750 COMMERCIAL AVE
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78221-3117
Mailing Address - Country:US
Mailing Address - Phone:210-922-7000
Mailing Address - Fax:210-646-9606
Practice Address - Street 1:17323 IH 35 N STE 113
Practice Address - Street 2:
Practice Address - City:SCHERTZ
Practice Address - State:TX
Practice Address - Zip Code:78154-1278
Practice Address - Country:US
Practice Address - Phone:210-922-7000
Practice Address - Fax:210-646-9606
Is Sole Proprietor?:No
Enumeration Date:2017-09-28
Last Update Date:2021-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP135171208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics