Active NPI
Roman Lopez
- Physical Therapy Assistant
- El Paso, TX
National Provider Identifier
1225514904
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 2098176
- Practice address
- 11351 James Watt Dr
El Paso, TX 79936-6627 - Phone
- (915) 849-6602
- NPI assigned
- Jul 16, 2018
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 2098176 | TX | Primary |
Addresses
Primary practice location
11351 James Watt Dr
El Paso, TX 79936-6627
Mailing address
13105 Kestrel Ave
Horizon City, TX 79928-6210
Phone (915) 235-5200
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2098176 | TX | MD | Physical Therapy Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Akomolafe Professional Corporation | Single Specialty | Past | Accepting new patients |
Organizations & group practices 1
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": "1531699200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1531699200000",
"number": "1225514904",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13105 KESTREL AVE",
"city": "HORIZON CITY",
"state": "TX",
"postal_code": "799286210",
"telephone_number": "915-235-5200"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11351 JAMES WATT DR",
"city": "EL PASO",
"state": "TX",
"postal_code": "799366627",
"telephone_number": "915-849-6602"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LOPEZ",
"first_name": "ROMAN",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2018-07-16",
"last_updated": "2018-07-16",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Physical Therapy Assistant",
"state": "TX",
"license": "2098176",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in El Paso, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.