Provider Demographics
NPI:1902241243
Name:LUCIANO LOPEZ
Entity Type:Organization
Organization Name:LUCIANO LOPEZ
Other - Org Name:EXCLUSIVE DME & SUPPLIES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LUCIANO
Authorized Official - Middle Name:
Authorized Official - Last Name:LOPEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-821-0144
Mailing Address - Street 1:102 N SALINAS BLVD
Mailing Address - Street 2:SUITE B
Mailing Address - City:DONNA
Mailing Address - State:TX
Mailing Address - Zip Code:78537-2926
Mailing Address - Country:US
Mailing Address - Phone:956-844-0144
Mailing Address - Fax:956-787-2546
Practice Address - Street 1:102 N SALINAS BLVD
Practice Address - Street 2:SUITE B
Practice Address - City:DONNA
Practice Address - State:TX
Practice Address - Zip Code:78537-2926
Practice Address - Country:US
Practice Address - Phone:956-844-0144
Practice Address - Fax:956-787-2546
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-30
Last Update Date:2013-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies