Provider Demographics
NPI:1396119293
Name:LOZANO, PEDRO (LMT)
Entity type:Individual
Prefix:
First Name:PEDRO
Middle Name:
Last Name:LOZANO
Suffix:
Gender:M
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2908 JEFFERSON AVE
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78504-6054
Mailing Address - Country:US
Mailing Address - Phone:956-569-7073
Mailing Address - Fax:
Practice Address - Street 1:214 N 16TH ST
Practice Address - Street 2:SUITE 129
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78501-4735
Practice Address - Country:US
Practice Address - Phone:956-569-7073
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-11-17
Last Update Date:2015-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXMT115606225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist