Individual provider Active NPI

Manuel Antonio Lopez, M.D.

  • Otolaryngology/Facial Plastic Surgery Physician
  • San Antonio, TX
National Provider Identifier
1770505984
Registry record updated Jun 25, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology/Facial Plastic Surgery PhysicianTaxonomy code 207YX0905X
License
M2695 Issued in TX
Practice address
18322 Sonterra PL
Ste 107
San Antonio, TX 78258-4196
Phone
(830) 328-4206
Fax
(210) 966-9106
NPI assigned
Jul 24, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X M2695 TX
Otolaryngology/Facial Plastic Surgery Physician 207YX0905X M2695 TX Primary

Addresses

Primary practice location

18322 Sonterra PL
Ste 107
San Antonio, TX 78258-4196

Mailing address

PO Box 591819
Ste 5104
San Antonio, TX 78259-0140
Phone (210) 495-5771

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051229000307 TX Practitioner - OtolaryngologyPractitioner - Plastic and Reconstructive Surgery 0345146072 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
OtolaryngologyAlso: Plastic and Reconstructive Surgery
Education
University of Louisville School of Medicine, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

18322 Sonterra PL
Suite 107
San Antonio, TX 78258-4196
Phone (210) 830-4206

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Aesthetics of Texas, PLLC CurrentSince Mar 11, 2016 Accepting new patients
South Texas Ambulatory Surgery Center, LLC PastSince May 16, 2011 Accepting new patients

Locations

109 Falls Ct
Ste 100
Boerne, TX 78006
Phone (210) 495-5771

1314 E Sonterra Blvd
Ste 5104
San Antonio, TX 78258
Phone (210) 495-2367

18322 Sonterra Pl
Ste 107
San Antonio, TX 78258
Phone (210) 495-5771

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1153699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782345600000",
    "number": "1770505984",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 591819",
            "address_2": "STE 5104",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782590140",
            "telephone_number": "210-495-5771",
            "fax_number": "210-495-0155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18322 SONTERRA PL",
            "address_2": "STE 107",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782584196",
            "telephone_number": "830-328-4206",
            "fax_number": "210-966-9106"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOPEZ",
        "first_name": "MANUEL",
        "middle_name": "ANTONIO",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-24",
        "last_updated": "2026-06-25",
        "certification_date": "2026-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "TX",
            "license": "M2695",
            "primary": false
        },
        {
            "code": "207YX0905X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Otolaryngology/Facial Plastic Surgery",
            "state": "TX",
            "license": "M2695",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.