Provider Demographics
NPI:1134474992
Name:LOZANO, VANESSA (PHARMD)
Entity Type:Individual
Prefix:
First Name:VANESSA
Middle Name:
Last Name:LOZANO
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:VANESSA
Other - Middle Name:
Other - Last Name:LUJAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:529 BLUEHAW DR
Mailing Address - Street 2:
Mailing Address - City:GEORGETOWN
Mailing Address - State:TX
Mailing Address - Zip Code:78628-7063
Mailing Address - Country:US
Mailing Address - Phone:512-509-3622
Mailing Address - Fax:
Practice Address - Street 1:425 UNIVERSITY BLVD STE 165
Practice Address - Street 2:
Practice Address - City:ROUND ROCK
Practice Address - State:TX
Practice Address - Zip Code:78665-1056
Practice Address - Country:US
Practice Address - Phone:512-509-3606
Practice Address - Fax:512-509-3610
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-18
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX51632183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist