MEDICARE: JOSE M.LOZANO MD, PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	G7268	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1679526586
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JOSE M.LOZANO MD, PA

Provider Business Mailing Address
First Line	:	PO BOX 549
Second Line	:
City	:	PREMONT
State	:	TX
Zip	:	78375-0549
Country	:	US
Telephone Number	:	361-325-9291
Fax Number	:	361-325-9390

Provider Business Practice Location Address
First Line	:	107 E ADAMS ST
Second Line	:
City	:	FALFURRIAS
State	:	TX
Zip	:	78355-4301
Country	:	US
Telephone Number	:	361-325-9291
Fax Number	:	361-325-3903

Authorized Official
Title or Position	:	MD
Name	:	JOSE MANUEL LOZANO
Credential	:	MD
Telephone Number	:	361-325-9291

Provider Enumeration Date	:	05/19/2006
Last Update Date	:	12/16/2009

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