Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Stacey Lopez, PA-C

Individual provider Physician Assistant · NPI 1134769292

Stacey Lopez, PA-C is a Physician Assistant in Burleson, Texas. Qualified in 2018, 8 years ago. Practices with Prestige Dermatology PLLC, a 5-clinician group and accepts Medicare assignment. Licensed in Texas.

Years since qualifying
8
Licensed in
TX
In the registry since
2020
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

621 SW Johnson Ave Ste C
Burleson, TX 76028-5834
Phone: (817) 766-7421
Fax: (817) 447-8100
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence PA13099 (TX)

Record details

NPI number1134769292
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorNo
NPI enumeratedJanuary 7, 2020
Last updated in NPPESMay 20, 2022
Certification dateMay 20, 2022

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2018 (8 years in practice)
Group practice Prestige Dermatology Pllc — 5 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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