Provider Demographics
NPI:1881696227
Name:CHERYL P LOPEZ DO PA
Entity type:Organization
Organization Name:CHERYL P LOPEZ DO PA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CHERYL
Authorized Official - Middle Name:PAN
Authorized Official - Last Name:LOPEZ
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:214-618-7952
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
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-15
Last Update Date:2025-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK0903207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1076462OtherFIRST HEALTH INSURANCE
TX527359OtherDESERET MUTUAL INSURANCE
TX104282OtherHEALTH PARTNERS CLAIM
TX147888807OtherUNITED HEALTHCARE
TX82610FOtherBCBS OF TX
TXP000047281OtherNORTHTEXAS HEALTH NETWORK
TX1015218OtherAETNA INSURANCE
TX2559446OtherHEALTHMARKET INSURANCE
TX0041BHOtherBCBS OF TX (GROUP ID #)
TX21149563445OtherBEECHSTREET INSURANCE
TX7240640007OtherCIGNA INSURANCE
TX45D0939472OtherCLIA
TX5018550OtherAETNA INSURANCE
TXP082610FDMedicaid