Oluwaseyi Anna Lopez, PA-C, LPC

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA09152 Issued in TX

Practice address

11673 Jollyville Rd Ste 201
Austin, TX 78759-4211

Phone

(512) 579-0304

NPI assigned

Jan 4, 2013

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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.

• Bcep PA

  • Emergency Medical Services (Emergency Medicine) Physician
  • Austin, TX
  • NPI 1629291844
  NPD (past)
• Middle Tennessee Primary Care PC

  • Family Medicine Physician
  • Pleasant View, TN
  • NPI 1588996656
  NPD (past)

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

{
    "created_epoch": "1357257600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709510400000",
    "number": "1174860696",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11673 JOLLYVILLE RD STE 201",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787594211",
            "telephone_number": "512-579-0304"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11673 JOLLYVILLE RD STE 201",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787594211",
            "telephone_number": "512-579-0304"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9804 Nightjar Dr Unit A",
            "address_purpose": "LOCATION",
            "city": "Austin",
            "state": "TX",
            "postal_code": "787485832",
            "country_code": "US",
            "telephone_number": "423-240-4192",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LOPEZ",
        "first_name": "OLUWASEYI",
        "middle_name": "ANNA",
        "name_prefix": "Ms.",
        "credential": "PA-C, LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-01-04",
        "last_updated": "2024-03-04",
        "certification_date": "2024-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "88249",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA09152",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Melissa Lopez, LCSW
• Miguel Antonio Lopez, RN
• Myla Lopez
• Natalia Lopez, RN
• Nicolas Lopez, RN
• Richard A Lopez, PHARMD
• Sarah Josephine Lopez
• Stormy Lopez, NP
• Tiffini Lopez
• Valentin Vidal Lopez, CSFA

• Physician Assistant in Austin, TX
• Providers in Austin, TX by specialty
• Physician Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2024; 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.