Basic Information
| Provider Information | |||||||||
| NPI: | 1730279068 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | LOPEZ | ||||||||
| FirstName: | EVA | ||||||||
| MiddleName: | JEANETTE | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | GC PHYSICIAN SERVICES | ||||||||
| Address2: | 2318 SAN PEDRO STE 12 | ||||||||
| City: | SAN ANTONIO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 782121901 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2102596338 | ||||||||
| FaxNumber: | 3862047372 | ||||||||
| Practice Location | |||||||||
| Address1: | 5401 SOUTH ST | ||||||||
| Address2: | |||||||||
| City: | LINCOLN | ||||||||
| State: | NE | ||||||||
| PostalCode: | 685062150 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2102596338 | ||||||||
| FaxNumber: | 3862047372 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/16/2006 | ||||||||
| LastUpdateDate: | 08/10/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 08/05/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | H4499 | TX | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207R00000X | E-9796 | AR | N | Allopathic & Osteopathic Physicians | Internal Medicine | 2083B0002X | H4499 | TX | N | 207R00000X | 30368 | NE | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.