Healthcare Provider Details

I. General information

NPI: 1861653487
Provider Name (Legal Business Name): JASON GENE LOZANO M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/17/2008
Last Update Date: 06/14/2026
Certification Date: 06/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2805 5TH ST STE 210A
RAPID CITY SD
57701-7330
US

IV. Provider business mailing address

945 MCKINNEY ST # 10399
HOUSTON TX
77002-6308
US

V. Phone/Fax

Practice location:
  • Phone: 605-343-2267
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207ZF0201X
TaxonomyForensic Pathology Physician
License Number18537
License Number StateSD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: