Individual provider Active NPI

Kirsten L Lopez, CPNP-PC

  • Pediatric Nurse Practitioner
  • Conroe, TX
National Provider Identifier
1114671633
Registry record updated Jul 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
1069762 Issued in TX
Practice address
690 S Loop 336 W Ste 110
Conroe, TX 77304-3320
Phone
(936) 539-8190
NPI assigned
Feb 4, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 1069762 TX Primary

Addresses

Primary practice location

690 S Loop 336 W Ste 110
Conroe, TX 77304-3320

Mailing address

122 W John Carpenter Fwy Ste 420
Irving, TX 75039-2014
Phone (972) 957-3000

Other practice location 1

4801 Alberta Ave
El Paso, TX 79905-2707
Phone (915) 215-5700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250722001270 TX Practitioner - Nurse Practitioner 5799291266 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
1069762TXMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Texas Tech University Health Sciences Center El Paso Current Accepting new patients
Pediatric Healthcare of Northwest Houston PA Pediatrics CurrentSince Jun 11, 2023 Accepting new patients
Texas Tech University Health Sciences Center El Paso CurrentSince Sep 1, 2025 Accepting new patients
Texas Tech University Health Sciences Center El Paso CurrentSince Sep 1, 2025 Accepting new patients
Topcare Medical Group Inc PastSince Jun 11, 2023 Accepting new patients
Texas Tech University Health Sciences Center Odessa Past Accepting new patients

Locations

690 S Loop 336 W
Ste 110
Conroe, TX 77304
Phone (936) 539-8190

4800 Alberta Ave
El Paso, TX 79905
Phone (915) 215-5666

4801 Alberta Ave
El Paso, TX 79905
Phone (915) 215-5200

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1643932800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752192000000",
    "number": "1114671633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "122 W JOHN CARPENTER FWY STE 420",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "750392014",
            "telephone_number": "972-957-3000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "690 S LOOP 336 W STE 110",
            "city": "CONROE",
            "state": "TX",
            "postal_code": "773043320",
            "telephone_number": "936-539-8190"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4801 Alberta Ave",
            "address_purpose": "LOCATION",
            "city": "El Paso",
            "state": "TX",
            "postal_code": "799052707",
            "country_code": "US",
            "telephone_number": "915-215-5700",
            "fax_number": "915-215-8872",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LOPEZ",
        "first_name": "KIRSTEN",
        "middle_name": "L",
        "credential": "CPNP-PC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-02-04",
        "last_updated": "2025-07-11",
        "certification_date": "2025-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "TX",
            "license": "1069762",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Conroe, TX

Sources for this page

Verify at the official NPI Registry.