Individual provider Active NPI

Ivette C Lozano, M.D.

  • Medical Specialty Clinic/Center
  • Dallas, TX
National Provider Identifier
1376651117
Registry record updated Oct 21, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Specialty Clinic/CenterTaxonomy code 261QM2500X
License
J4310 Issued in TX
Practice address
10425 Garland Rd
Dallas, TX 75218-2926
Phone
(214) 660-1616
Fax
(214) 660-1628
NPI assigned
Aug 29, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 21, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Specialty Clinic/Center 261QM2500X J4310 TX Primary

Addresses

Primary practice location

10425 Garland Rd
Dallas, TX 75218-2926

Mailing address

10425 Garland Rd
Dallas, TX 75218-2926
Phone (214) 660-1616

Other identifiers 1

IdentifierTypeStateIssuer
135757601MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041209000152 TX Practitioner - Family PracticePractitioner - Emergency Medicine 5092771220

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Emergency Medicine
Education
Texas Tech University Health Science Center School of Medicine, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

10425 Garland Rd
Dallas, TX 75218-2926

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
J4310TXMDMedical Specialty Clinic/Center

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1156809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1445385600000",
    "number": "1376651117",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10425 GARLAND RD",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752182926",
            "telephone_number": "214-660-1616",
            "fax_number": "214-660-1628"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10425 GARLAND RD",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752182926",
            "telephone_number": "214-660-1616",
            "fax_number": "214-660-1628"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOZANO",
        "first_name": "IVETTE",
        "middle_name": "C",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-29",
        "last_updated": "2015-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "TX",
            "license": "J4310",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "135757601",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.