Jorge Luis Lopez

Primary specialty

Physical TherapistTaxonomy code 225100000X

Practice address

12702 Toepperwein Rd Ste 120
Live Oak, TX 78233-3208

Phone

(210) 653-4420

NPI assigned

Apr 25, 2022

Last updated

Apr 25, 2022By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2022

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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

• Buckner Retirement Services, Inc.

  dba Buckner Villa Siesta Home

  • Assisted Living Facility
  • Austin, TX
  • NPI 1841301868

  Physical Therapist

  Medicare reassignment NPD

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

{
    "created_epoch": "1650844800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650844800000",
    "number": "1306580576",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1420 ANHALT DR # 50B",
            "city": "PFLUGERVILLE",
            "state": "TX",
            "postal_code": "786606110",
            "telephone_number": "915-240-0866"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12702 TOEPPERWEIN RD STE 120",
            "city": "LIVE OAK",
            "state": "TX",
            "postal_code": "782333208",
            "telephone_number": "210-653-4420"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOPEZ",
        "first_name": "JORGE",
        "middle_name": "LUIS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-04-25",
        "last_updated": "2022-04-25",
        "certification_date": "2022-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lone Star State Dermatology Clinic PLLC
• Elizabeth Kay Long, FNP
• Joao Lopes, PT
• Deryck Bryan Lopez Garcia, DPT
• Gracie Ann Lopez
• Orlando Lopez, PA-C
• Lydia Lozano, BCABA
• Tori Lucas
• Joseph Renteria Luna III, M.D.
• Jordan M Lyssy

• Physical Therapist in Live Oak, TX
• Providers in Live Oak, TX by specialty
• Physical Therapist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.