Provider Demographics
NPI:1487346086
Name:LOPEZ, ANNETTE SARAHI (OTR)
Entity type:Individual
Prefix:
First Name:ANNETTE
Middle Name:SARAHI
Last Name:LOPEZ
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:617 JO ANN LN
Mailing Address - Street 2:
Mailing Address - City:BROWNSVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78520-4532
Mailing Address - Country:US
Mailing Address - Phone:956-518-6065
Mailing Address - Fax:
Practice Address - Street 1:401 BUSINESS 83
Practice Address - Street 2:
Practice Address - City:DONNA
Practice Address - State:TX
Practice Address - Zip Code:78537-3089
Practice Address - Country:US
Practice Address - Phone:956-378-0307
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-22
Last Update Date:2023-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX123516225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics