Provider Demographics
NPI:1396948691
Name:LOZANO, LEONEL J JR (MS, OTR)
Entity type:Individual
Prefix:MR
First Name:LEONEL
Middle Name:J
Last Name:LOZANO
Suffix:JR
Gender:M
Credentials:MS, OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 S. FREDERICK
Mailing Address - Street 2:
Mailing Address - City:EDCOUCH
Mailing Address - State:TX
Mailing Address - Zip Code:78538
Mailing Address - Country:US
Mailing Address - Phone:956-262-3009
Mailing Address - Fax:
Practice Address - Street 1:1102 W TRENTON RD
Practice Address - Street 2:
Practice Address - City:EDINBURG
Practice Address - State:TX
Practice Address - Zip Code:78539-9105
Practice Address - Country:US
Practice Address - Phone:956-388-6000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX112256225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist