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LAS FUENTES MEDICAL CLINIC
NPI 1619548104
Family Medicine in Mission, TX

Active since July 06, 2021CLIA 45D2240377 · Waiver
1400 W GRIFFIN PARK, SUITE 1, MISSION, TX 78572(956) 997-0106(956) 997-0105 Get Directions Write a Review

NPPES record last updated: December 9, 2021. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Dec 9, 2021, Jul 29, 2021, Jul 6, 2021 (3 updates tracked since 2021).

About Las Fuentes Medical Clinic NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

LAS FUENTES MEDICAL CLINIC (NPI 1619548104) is a healthcare organization registered as a family medicine in Mission, Texas and active in the NPI registry since July 2021. The organization holds a CLIA Waiver certificate valid through October 18, 2027 and lists Roberto Mauro Lopez, President, as its authorized official.

NPPES Registry Identity

NPI1619548104
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameROBERTO MURO LOPEZ MD PA
Location Address1400 W GRIFFIN PARK, SUITE 1Mission, TX 78572-0001
Mailing Address1400 W Griffin Park, Suite 1Mission, TX 78572-0001 · (956) 997-0106 · Fax (956) 997-0105
Phone(956) 997-0106
Fax(956) 997-0105
Organization SubpartNo
Authorized OfficialRoberto Mauro LopezPresident · (956) 997-0106
Enumeration DateJuly 6, 2021
Last NPPES UpdateDecember 9, 20213 updates tracked since enumeration
NPPES CertifiedDecember 9, 2021
✔ NPI 1619548104 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
1400 W GRIFFIN PARK, Mission, TX 78572
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Other Names 1

Doing Business AsLas Fuentes Medical Clinic

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Texas.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Las Fuentes Medical Clinic is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Las Fuentes Medical Clinic, which bills Medicare for the services this clinician delivers.

Clinician (1)

Roberto Lopez, M.D
Family Practice
NPI 1740662840
1400 W GRIFFIN PARK SUITE 1
Mission, TX 78572
(956) 598-5423
✔ PECOS✔ Accepts MedicareSame address

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 45D2240377

Las Fuentes Medical Clinic · Mission, TX
Active · expires Oct 18, 2027
CLIA Number45D2240377
Laboratory TypePhysician Office
Certificate Effective DateOctober 19, 2025
Certificate Expiration DateOctober 18, 2027
Laboratory DirectorRoberto M. Lopez
Laboratory Phone(956) 997-0106
Laboratory LocationLas Fuentes Medical Clinic1400 W Griffin Pkwy Suite 1, Mission, TX 78572
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Roberto Muro Lopez MD PA's NPI number?

The NPI number for Roberto Muro Lopez MD PA is 1619548104. It was assigned to this organization in the NPPES registry on July 6, 2021. The provider is doing business as Las Fuentes Medical Clinic.

Where is Roberto Muro Lopez MD PA located?

Roberto Muro Lopez MD PA is located at 1400 W Griffin Park Suite 1, Mission, TX 78572. The listed phone number is (956) 997-0106.

What is Roberto Muro Lopez MD PA's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Roberto Muro Lopez MD PA enrolled in Medicare?

Yes. Roberto Muro Lopez MD PA is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Roberto Muro Lopez MD PA?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Family Practice) reassigns their Medicare billing to Roberto Muro Lopez MD PA. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Roberto Muro Lopez MD PA hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 45D2240377) is associated with this NPI, valid through October 18, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Roberto Muro Lopez MD PA accept?

Health plans from Blue Cross and Blue Shield of Texas list Roberto Muro Lopez MD PA as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Roberto Muro Lopez MD PA was last updated on December 9, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.