Individual provider Active NPI

Rosa Cordova-Lopez

  • Family Nurse Practitioner
  • Humble, TX
National Provider Identifier
1760018014
Registry record updated Mar 19, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP145593 Issued in TX
Practice address
18980 W Memorial Dr Ste 100
Humble, TX 77338-4472
Phone
(832) 644-8930
NPI assigned
Mar 19, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X AP145593 TX Primary

Addresses

Primary practice location

18980 W Memorial Dr Ste 100
Humble, TX 77338-4472

Mailing address

5403 McCracken Rd
Houston, TX 77032-4308

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200824000170 TX Practitioner - Nurse Practitioner 3375969249 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
AP145593TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Rajiv Agarwal MD PA CurrentSince Apr 18, 2020 Accepting new patients
Rajiv Agarwal MD PA Current Accepting new patients

Locations

18835 McKay Dr
Humble, TX 77338
Phone (832) 644-8930

18980 W Memorial Dr
Ste 100
Humble, TX 77338
Phone (832) 644-8930

21703 Kingsland Blvd
Ste 100
Katy, TX 77450
Phone (281) 769-1015

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/CACGBD

Organizations & group practices 2

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": "1584576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1584576000000",
    "number": "1760018014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5403 MCCRACKEN RD",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770324308"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18980 W MEMORIAL DR STE 100",
            "city": "HUMBLE",
            "state": "TX",
            "postal_code": "773384472",
            "telephone_number": "832-644-8930"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORDOVA-LOPEZ",
        "first_name": "ROSA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-03-19",
        "last_updated": "2020-03-19",
        "certification_date": "2020-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP145593",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Humble, TX

Sources for this page

Verify at the official NPI Registry.