NPIMap

Organization Active NPI

Roberto Muro Lopez MD PA

  • Family Medicine Physician
  • Mission, TX
National Provider Identifier
1619548104
Registry record updated Dec 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
ROBERTO MURO LOPEZ MD PA
Practice address
1400 W Griffin Park
Suite 1
Mission, TX 78572-0001
Phone
(956) 997-0106
Fax
(956) 997-0105
NPI assigned
Jul 6, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 9, 2021

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

Authorized official

Name
Dr. Roberto Mauro Lopez, M.D.NPI 1740662840
Title
President
Phone
(956) 997-0106

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

1400 W Griffin Park
Suite 1
Mission, TX 78572-0001

Mailing address

1400 W Griffin Park
Suite 1
Mission, TX 78572-0001
Phone (956) 997-0106

Other names 1

  • Las Fuentes Medical Clinic Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210727003964 TX Part B Supplier - Clinic/Group Practice 5193128205 Receives reassigned benefits from 1 practitioner
Practice locations: Mission, TX

National Provider Directory

National Provider Directory
Tax ID family
Las Fuentes Medical Clinic2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1625529600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1639008000000",
    "number": "1619548104",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 W GRIFFIN PARK",
            "address_2": "SUITE 1",
            "city": "MISSION",
            "state": "TX",
            "postal_code": "785720001",
            "telephone_number": "956-997-0106",
            "fax_number": "956-997-0105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 W GRIFFIN PARK",
            "address_2": "SUITE 1",
            "city": "MISSION",
            "state": "TX",
            "postal_code": "785720001",
            "telephone_number": "956-997-0106",
            "fax_number": "956-997-0105"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROBERTO MURO LOPEZ MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-07-06",
        "last_updated": "2021-12-09",
        "certification_date": "2021-12-09",
        "status": "A",
        "authorized_official_last_name": "LOPEZ",
        "authorized_official_first_name": "ROBERTO",
        "authorized_official_middle_name": "MAURO",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "956-997-0106",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Las Fuentes Medical Clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Las Fuentes Medical Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Mission, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.