Basic Information
| Provider Information | |||||||||
| NPI: | 1558016857 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | LOPEZ | ||||||||
| FirstName: | JOSEPH | ||||||||
| MiddleName: | LEE | ||||||||
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| Mailing Information | |||||||||
| Address1: | 716 S 9TH ST | ||||||||
| Address2: | |||||||||
| City: | HASKELL | ||||||||
| State: | TX | ||||||||
| PostalCode: | 795217108 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9407814024 | ||||||||
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| Practice Location | |||||||||
| Address1: | 7951 COLLIN MCKINNEY PKWY STE 200 | ||||||||
| Address2: | |||||||||
| City: | MCKINNEY | ||||||||
| State: | TX | ||||||||
| PostalCode: | 750707843 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4692949075 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 02/15/2022 | ||||||||
| LastUpdateDate: | 02/15/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 02/15/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | 55911 | TX | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.