Provider Demographics
NPI:1902876048
Name:LOZADA, GERARD N (OD)
Entity Type:Individual
Prefix:DR
First Name:GERARD
Middle Name:N
Last Name:LOZADA
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:7355 W 97TH ST
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66212-2210
Mailing Address - Country:US
Mailing Address - Phone:913-648-2021
Mailing Address - Fax:913-648-7762
Practice Address - Street 1:7355 W 97TH ST
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66212-2210
Practice Address - Country:US
Practice Address - Phone:913-648-2021
Practice Address - Fax:913-648-7762
Is Sole Proprietor?:No
Enumeration Date:2006-01-23
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS13813152WC0802X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
KSML0046638OtherDEA NUMBER
KSML0046638OtherDEA NUMBER