Provider Demographics
NPI:1437336864
Name:LOPEZ, CHERYL PAN (DO)
Entity type:Individual
Prefix:DR
First Name:CHERYL
Middle Name:PAN
Last Name:LOPEZ
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2097 N COLLINS BLVD STE 198
Mailing Address - Street 2:
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75080-2684
Mailing Address - Country:US
Mailing Address - Phone:972-680-9983
Mailing Address - Fax:972-680-9163
Practice Address - Street 1:2097 N COLLINS BLVD STE 198
Practice Address - Street 2:
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75080-2684
Practice Address - Country:US
Practice Address - Phone:972-680-9983
Practice Address - Fax:972-680-9163
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-28
Last Update Date:2025-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK0903207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
1015218OtherAETNA
21149563445OtherBEECHSTREET
5018550OtherAETNA
7240640007OtherCIGNA
2559446OtherHEALTHMARKET
TX82610FOtherBCBSTX
TXP082610FDMedicaid
104282OtherHEALTH PARTNERS
1076462OtherFIRST HEALTH
527359OtherDESERET
82610FMedicare PIN
TX82610FOtherBCBSTX
TXP082610FDMedicaid