Provider Demographics
NPI:1912577669
Name:LOZOYA-MEZA, MONICA (RTRMRMRSO)
Entity Type:Individual
Prefix:
First Name:MONICA
Middle Name:
Last Name:LOZOYA-MEZA
Suffix:
Gender:F
Credentials:RTRMRMRSO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6863 HAWK RD
Mailing Address - Street 2:
Mailing Address - City:LAS CRUCES
Mailing Address - State:NM
Mailing Address - Zip Code:88012-6257
Mailing Address - Country:US
Mailing Address - Phone:575-312-9990
Mailing Address - Fax:575-571-4310
Practice Address - Street 1:4440 N SONOMA RANCH BLVD STE G
Practice Address - Street 2:
Practice Address - City:LAS CRUCES
Practice Address - State:NM
Practice Address - Zip Code:88011-7335
Practice Address - Country:US
Practice Address - Phone:575-259-3069
Practice Address - Fax:575-571-4310
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-25
Last Update Date:2021-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMRRT05592471M1202X
NMRRT00103247100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247100000XTechnologists, Technicians & Other Technical Service ProvidersRadiologic Technologist
No2471M1202XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistMagnetic Resonance Imaging