Individual ProviderJerry LopezPhysician AssistantPhysician Assistants & Advanced Practice Nursing ProvidersPractice Address4700 Seton Center Pkwy, Suite 200, Austin, TX 78759-5295(512) 439-1000PECOS EnrollmentBased on the most recent information from CMS, provider Jerry Lopez is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.Part BMedicare Part BEnrolledHHAHome Health AgencyEnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records yesterday at 12:57 PM.Profile DetailsProvider ID1710947650Provider TypeIndividualFull NameLopez, JerryCredentialP.A.GenderMaleSole ProprietorNoEnumeration Date3/24/2006Last Updated3/6/2025Contact InformationPractice LocationPractice Address4700 Seton Center Pkwy, Suite 200, Austin, TX 78759-5295Phone(512) 439-1000Fax(512) 439-1081Mailing LocationMailing Address4700 Seton Center Pkwy, Suite 200, Austin, TX 78759-5295Phone(512) 439-1000Fax(512) 439-1081Provider TaxonomiesCodeDescriptionLicenseCode363AS0400XPrimaryDescriptionPhysician AssistantPhysician Assistants & Advanced Practice Nursing ProvidersLicensePA03921TexasCode363A00000XDescriptionPhysician AssistantPhysician Assistants & Advanced Practice Nursing ProvidersLicensePA03921Texas