Provider Demographics
NPI:1700555455
Name:LOZANO, GREGORIO III (LPC)
Entity Type:Individual
Prefix:MR
First Name:GREGORIO
Middle Name:
Last Name:LOZANO
Suffix:III
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18670 FORTY SIX PKWY UNIT I
Mailing Address - Street 2:
Mailing Address - City:SPRING BRANCH
Mailing Address - State:TX
Mailing Address - Zip Code:78070-6911
Mailing Address - Country:US
Mailing Address - Phone:830-481-1644
Mailing Address - Fax:
Practice Address - Street 1:18670 FORTY SIX PKWY UNIT I
Practice Address - Street 2:
Practice Address - City:SPRING BRANCH
Practice Address - State:TX
Practice Address - Zip Code:78070-6911
Practice Address - Country:US
Practice Address - Phone:830-481-1644
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-07
Last Update Date:2021-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX81222101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health