| Evonne L Lopez, FNP | |
|
17202 State Highway 36 S, Somerville, TX 77879-5264 | |
| (979) 383-2340 | |
| Not Available |
| Full Name | Evonne L Lopez |
|---|---|
| Gender | Female |
| Speciality | Nurse Practitioner - Family |
| Location | 17202 State Highway 36 S, Somerville, Texas |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1346906088 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 163WH1000X | Registered Nurse - Hospice | 714080 (Texas) | Secondary |
| 363LF0000X | Nurse Practitioner - Family | 1098371 (Texas) | Primary |
| Entity Name | Conviva Medical Center Management Of Texas, P.a. |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1770988990 PECOS PAC ID: 8729302278 Enrollment ID: O20150112000488 |
| Mailing Address | Practice Location Address |
|---|---|
| Evonne L Lopez, FNP 1500 University Dr E Ste 100, College Station, TX 77840-2600 Ph: (979) 383-2340 | Evonne L Lopez, FNP 17202 State Highway 36 S, Somerville, TX 77879-5264 Ph: (979) 383-2340 |
Elizabeth Stacy Varley, APRN Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 600 Memory Lane, Somerville, TX 77879 Phone: 979-596-1441 Fax: 979-596-2237 | |
Crystal James Mable, FNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 17202 State Highway 36 S, Somerville, TX 77879 Phone: 979-596-1441 | |
Mr. William Sherman Whiting Iv, FNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 11715 County Road 162, Somerville, TX 77879 Phone: 979-575-6956 |