NPIMap

Individual provider Active NPI

Roberto Lopez, M.D

  • Family Medicine Physician
  • Mission, TX
National Provider Identifier
1740662840
Registry record updated Dec 7, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
31699-R Issued in PR
Practice address
1400 W Griffin Park
Suite 1
Mission, TX 78572-0001
Phone
(956) 598-5423
NPI assigned
Jun 24, 2015
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 7, 2021

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 31699-R PR 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) 563-7046

Other practice location 1

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

Other names 1

  • Roberto Mauro Lopez Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180627002439 TX Practitioner - Family Practice 2668728007 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Legacy Healthcare Services IncGroup PAC ID 2163339722, 3,431 clinicians

Practice addresses (Care Compare)

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

1400 W Griffin Pkwy
1 Las Fuentes Medical Clinic
Mission, TX 78572-0001
Phone (956) 563-7046

800 College Pkwy
Lewisville, TX 75077-3503
Phone (972) 420-8543

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
31699-RPRMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Roberto Muro Lopez MD PA Family Medicine CurrentSince Jul 13, 2021 Accepting new patients
Donna Medical Clinic, PLLC Family Medicine CurrentSince Jul 15, 2018 Accepting new patients
Roberto Mauro Lopez MD PA Family Medicine CurrentSince Aug 1, 2021 Accepting new patients

Locations

307 N Salinas Blvd
Donna, TX 78537
Phone (956) 464-2402

Organizations & group practices 4

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.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1435104000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638835200000",
    "number": "1740662840",
    "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": "956-563-7046"
        },
        {
            "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": "956-598-5423"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1400 W Griffin Pkwy",
            "address_2": "Suite 1",
            "address_purpose": "LOCATION",
            "city": "Mission",
            "state": "TX",
            "postal_code": "78572",
            "country_code": "US",
            "telephone_number": "956-997-0106",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LOPEZ",
        "first_name": "ROBERTO",
        "credential": "M.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-06-24",
        "last_updated": "2021-12-07",
        "certification_date": "2021-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PR",
            "license": "31699-R",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ROBERTO",
            "last_name": "LOPEZ",
            "middle_name": "MAURO",
            "credential": "M.D",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Mission, TX

Sources for this page

Verify at the official NPI Registry.