MEDICARE: MANJU LOZANO

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	207RG0300X	Geriatric Medicine (Internal Medicine) Physician	S8337	TX
2	390200000X	Student in an Organized Health Care Education/Training Program

General Provider Information

NPI Number	:	1154778595
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MANJU LOZANO

Provider Business Mailing Address
First Line	:	PO BOX 845347
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75284-7208
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5303 HARRY HINES BLVD 8TH FLOOR, STE 200
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75390-7419
Country	:	US
Telephone Number	:	214-645-8650
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/16/2016
Last Update Date	:	02/10/2026

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Directions to “ MANJU LOZANO ” Practice Location

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