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General NPI Number Information
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NPI Number | 1871265611
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Entity Type | Individual
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Provider Name | LISA MARGARET LOZANO PA
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Gender | Female
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Dates
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Enumeration Date | 09/30/2021
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Last Update Date | 09/30/2021
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Provider Practice Location Address
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Address Line | 4402 BROADWAY BLVD STE 1
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City | GARLAND
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State | TX
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Zip | 75043-3400
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Country | US
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Telephone | 972-240-1789
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Fax | 972-240-4615
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Provider Business Mailing Address
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Address Line | 4402 BROADWAY BLVD STE 1
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City | GARLAND
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State | TX
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Zip | 75043-3400
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Country | US
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Telephone | 972-240-1789
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Fax | 972-240-4615
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | 02359
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License Number State | TX
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