Individual provider Active NPI

Miriam Nayeli Lopez, FNP

  • Family Nurse Practitioner
  • Houston, TX
National Provider Identifier
1144983313
Registry record updated Mar 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1056785 Issued in TX
Practice address
11040 East Fwy
Houston, TX 77029-1931
Phone
(713) 453-8328
NPI assigned
Oct 14, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 1, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 1056785 TX Primary

Addresses

Primary practice location

11040 East Fwy
Houston, TX 77029-1931

Mailing address

4002 E Lindbergh CT
Baytown, TX 77521-2156
Phone (832) 597-0828

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
I20220725002409 TX Practitioner - Nurse Practitioner 4688055403 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

11040 E Fwy
Houston, TX 77029-1931
Phone (713) 453-8328

7900 Fannin St
Suite 4000
Houston, TX 77054-2935
Phone (713) 512-7500

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1056785TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Privia Medical Group Gulf Coast PLLC CurrentSince Jun 19, 2022 Accepting new patients
Privia Medical Group Gulf Coast, PLLC CurrentSince Jun 19, 2022 Accepting new patients

Locations

646 FM 517 Rd W
Dickinson, TX 77539
Phone (281) 309-9001

13125 East Fwy
Houston, TX 77015
Phone (713) 451-9969

7900 Fannin St
Ste 4000
Houston, TX 77054
Phone (713) 512-7027

1200 Binz St
Ste 1490
Houston, TX 77004
Phone (713) 512-7027

11040 East Fwy
Houston, TX 77029
Phone (713) 451-5935

10970 Shadow Creek Pkwy
Ste 100
Pearland, TX 77584
Phone (281) 398-8500

17510 W Grand Pkwy S
Ste 430
Sugar Land, TX 77479
Phone (713) 578-3820

Interoperability endpoints

  • Direct secure messaging: miriam.lopez.1@8042.direct.athenahealth.com

Organizations & group practices 2

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": "1634169600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677628800000",
    "number": "1144983313",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4002 E LINDBERGH CT",
            "city": "BAYTOWN",
            "state": "TX",
            "postal_code": "775212156",
            "telephone_number": "832-597-0828"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11040 EAST FWY",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770291931",
            "telephone_number": "713-453-8328"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOPEZ",
        "first_name": "MIRIAM",
        "middle_name": "NAYELI",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-10-14",
        "last_updated": "2023-03-01",
        "certification_date": "2023-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "1056785",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.