Provider Demographics
NPI:1821725466
Name:LOZANO, BRUNO IV (FNP-C)
Entity Type:Individual
Prefix:
First Name:BRUNO
Middle Name:
Last Name:LOZANO
Suffix:IV
Gender:M
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1614 JENI REY LN
Mailing Address - Street 2:
Mailing Address - City:EDINBURG
Mailing Address - State:TX
Mailing Address - Zip Code:78541-2581
Mailing Address - Country:US
Mailing Address - Phone:956-735-2784
Mailing Address - Fax:
Practice Address - Street 1:906 S BRIDGE AVE
Practice Address - Street 2:
Practice Address - City:WESLACO
Practice Address - State:TX
Practice Address - Zip Code:78596-7129
Practice Address - Country:US
Practice Address - Phone:956-447-8600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-03
Last Update Date:2022-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1087099363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily