Lopez-Vergara, Staci E

Lopez-Vergara, Staci E is an individual health care provider with primary practice located at 9840 N Beach St , Fort Worth TX 76244-6184. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Pediatrics, Physician Assistants & Advanced Practice Nursing Providers / Primary Care. Physician Assistants & Advanced Practice Nursing Providers / Pediatrics is her primary health care specialty. Lopez-Vergara, Staci E can be contacted via phone (817) 431-3898.

Contact Information

Primary practice address
9840 N Beach St Fort Worth TX 76244-6184
Phone: (817) 431-3898
Fax: (817) 379-1161
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Pediatrics 363LP0200X 755740 Texas
Physician Assistants & Advanced Practice Nursing Providers / Primary Care 363LP2300X AP122615 Texas
Physician Assistants & Advanced Practice Nursing Providers / Pediatrics 363LP0200X AP122615 Texas

Profile Details

NPI number 1407191323
LBN Legal business name Lopez-Vergara, Staci E
Credentials Certified Pediatric Nurse Practitioner (CPNP)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 4th, 2012
Last updated May 14th, 2024 - 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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