Roberto Mauro Lopez MD PA

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

ROBERTO MAURO LOPEZ MD PA

Practice address

1400 W Griffin Pkwy Suite 1
Mission, TX 78572

Phone

(956) 563-7046

NPI assigned

Jul 29, 2021

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Srikanth Nangavaram

Title

Cfo

Phone

(956) 215-6010

Specialties & licenses 1

Addresses

Other names 1

• Las Fuentes Medical Clinic Doing business as

Tax ID family

Las Fuentes Medical Clinic2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Roberto Muro Lopez MD PA

  • Family Medicine Physician
  • Mission, TX
  • NPI 1619548104
  NPD tax ID

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Roberto Lopez, M.D

  • Family Medicine Physician
  • Mission, TX
  • NPI 1740662840
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1627516800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1627516800000",
    "number": "1104599679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2509 SANDSTONE DR",
            "city": "MISSION",
            "state": "TX",
            "postal_code": "785742774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 W GRIFFIN PKWY SUITE 1",
            "city": "MISSION",
            "state": "TX",
            "postal_code": "78572",
            "telephone_number": "956-563-7046"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROBERTO MAURO LOPEZ MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-07-29",
        "last_updated": "2021-07-29",
        "certification_date": "2021-07-05",
        "status": "A",
        "authorized_official_last_name": "NANGAVARAM",
        "authorized_official_first_name": "SRIKANTH",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "956-215-6010"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Las Fuentes Medical Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Ann Marie Rivera, L.AC, LOTA
• Blanca Estela Rivera, LBSW
• Catalina Maria Luis Rivera, STA
• Christy Rivera, LMSW
• Arvic T. Roa, N.P.
• Roberto Muro Lopez MD PA
• Erica Marie Robles, FNP
• Ruben Rocha, FNP-C
• Rocking Horse Rehab, LLC
• Roda Enterprise

• Family Medicine Physician in Mission, TX
• Providers in Mission, TX by specialty
• Family Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.