Provider Demographics
NPI:1407950991
Name:LOZANO, RODOLFO M (MD)
Entity Type:Individual
Prefix:
First Name:RODOLFO
Middle Name:M
Last Name:LOZANO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2821 MICHAEL ANGELO
Mailing Address - Street 2:STE 100
Mailing Address - City:EDINBURG
Mailing Address - State:TX
Mailing Address - Zip Code:78539
Mailing Address - Country:US
Mailing Address - Phone:956-683-6073
Mailing Address - Fax:956-686-7507
Practice Address - Street 1:2821 MICHAEL ANGELO
Practice Address - Street 2:STE 100
Practice Address - City:EDINBURG
Practice Address - State:TX
Practice Address - Zip Code:78539
Practice Address - Country:US
Practice Address - Phone:956-683-6073
Practice Address - Fax:956-686-7507
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-12
Last Update Date:2022-08-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXL1927207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX122477605Medicaid
TXH48569Medicare UPIN