Individual provider Active NPI

Elsa Lopez, M.D.

  • Family Medicine Physician
  • Temple, TX
National Provider Identifier
1275608606
Registry record updated Jun 13, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
058698 Issued in GA
Practice address
4501 S General Bruce Dr
Suite 75
Temple, TX 76502-1469
Phone
(254) 743-1608
NPI assigned
Nov 21, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 13, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 058698 GA Primary

Addresses

Primary practice location

4501 S General Bruce Dr
Suite 75
Temple, TX 76502-1469

Mailing address

4501 S General Bruce Dr
Suite 75
Temple, TX 76502-1469
Phone (254) 743-1608

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130606000283 TX Order and Referring Only - Family PracticePractitioner - Family Practice 8820193758

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
058698GAMDFamily Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1164067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1371081600000",
    "number": "1275608606",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4501 S GENERAL BRUCE DR",
            "address_2": "SUITE 75",
            "city": "TEMPLE",
            "state": "TX",
            "postal_code": "765021469",
            "telephone_number": "254-743-1608"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4501 S GENERAL BRUCE DR",
            "address_2": "SUITE 75",
            "city": "TEMPLE",
            "state": "TX",
            "postal_code": "765021469",
            "telephone_number": "254-743-1608"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOPEZ",
        "first_name": "ELSA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-21",
        "last_updated": "2013-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "058698",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Temple, TX

Sources for this page

Verify at the official NPI Registry.