| Lopez Behavioral Pllc | |
|
6600 Montana Ave Ste P El Paso TX 79925-2149 | |
| (915) 312-2868 | |
| Not Available |
| Full Name | Lopez Behavioral Pllc |
|---|---|
| Speciality | Social Worker |
| Location | 6600 Montana Ave Ste P, El Paso, Texas |
| Authorized Official Name and Position | Jasmine Lopez (OWNER) |
| Authorized Official Contact | 9153122868 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lopez Behavioral Pllc 6600 Montana Ave Ste P El Paso TX 79925-2149 Ph: (915) 671-1371 | Lopez Behavioral Pllc 6600 Montana Ave Ste P El Paso TX 79925-2149 Ph: (915) 312-2868 |
| NPI Number | 1083328025 |
|---|---|
| Provider Enumeration Date | 01/12/2023 |
| Last Update Date | 03/06/2024 |
| Certification Date | 03/06/2024 |
| Medicare PECOS PAC ID | 9830564426 |
|---|---|
| Medicare Enrollment ID | O20230413000474 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1083328025 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Jasmine Desiree Lopez |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1528781275 PECOS PAC ID: 6507232501 Enrollment ID: I20221017001142 |
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