Individual provider Active NPI

Bianca E Lopez, AGPCNP-BC

  • Gerontology Nurse Practitioner
  • San Antonio, TX
National Provider Identifier
1336796408
Registry record updated May 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
AP142726 Issued in TX
Practice address
1200 Brooklyn Ave Ste 320
San Antonio, TX 78212-4810
Phone
(210) 229-7242
Fax
(210) 227-5092
NPI assigned
Aug 22, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 24, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X AP142726 TX
Gerontology Nurse Practitioner 363LG0600X AP142726 TX Primary

Addresses

Primary practice location

1200 Brooklyn Ave Ste 320
San Antonio, TX 78212-4810

Mailing address

3066 E Commerce St
San Antonio, TX 78220-1013

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
I20200709003572 TX Practitioner - Nurse Practitioner 1052734993 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
AP142726TXMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Barrio Comprehensive Family Health Care Center, Inc. CurrentSince Mar 25, 2024 Accepting new patients
Barrio Comprehensive Family Health Care Center, Inc. Current Accepting new patients
Barrio Comprehensive Family Health Care Center, Inc. CurrentSince Mar 25, 2024 Accepting new patients

Locations

3066 E Commerce St
San Antonio, TX 78220
Phone (210) 233-7062

1200 Brooklyn Ave
Ste 320
San Antonio, TX 78212
Phone (210) 225-5741

14625 Huebner Rd
San Antonio, TX 78230

1102 Barclay St
San Antonio, TX 78207
Phone (210) 434-0513

1200 Brooklyn Ave
Ste 365
San Antonio, TX 78212
Phone (210) 224-9616

10350 Bandera Rd
Ste 210
San Antonio, TX 78250
Phone (210) 688-0088

Organizations & group practices 3

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": "1566432000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716508800000",
    "number": "1336796408",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3066 E COMMERCE ST",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782201013",
            "fax_number": "210-227-5092"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 BROOKLYN AVE STE 320",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782124810",
            "telephone_number": "210-229-7242",
            "fax_number": "210-227-5092"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOPEZ",
        "first_name": "BIANCA",
        "middle_name": "E",
        "credential": "AGPCNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-22",
        "last_updated": "2024-05-24",
        "certification_date": "2024-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "AP142726",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "TX",
            "license": "AP142726",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.