Rivera Lopez, Edgardo

Rivera Lopez, Edgardo is an individual health care provider with primary practice located at 4301 Broadway , San Antonio TX 78209-6318. He recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Sports, which is considered as his primary health care specialty. Rivera Lopez, Edgardo can be contacted via phone (210) 829-6017.

Contact Information

Primary practice address
4301 Broadway San Antonio TX 78209-6318
Phone: (210) 829-6017
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Sports 2251S0007X 1362473 Texas

Profile Details

NPI number 1477288900
LBN Legal business name Rivera Lopez, Edgardo
Credentials PT, DPT, CSCS
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 19th, 2022
Last updated Jul 19th, 2022 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1477288900 NPPES
Texas MEDICAID 1362473

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