Provider Demographics
NPI:1063855872
Name:SMALLIGAN, LOWELL (MD)
Entity Type:Individual
Prefix:
First Name:LOWELL
Middle Name:
Last Name:SMALLIGAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8502 MONUMENT OAK
Mailing Address - Street 2:
Mailing Address - City:BOERNE
Mailing Address - State:TX
Mailing Address - Zip Code:78015-6514
Mailing Address - Country:US
Mailing Address - Phone:210-687-1280
Mailing Address - Fax:
Practice Address - Street 1:8502 MONUMENT OAK
Practice Address - Street 2:
Practice Address - City:BOERNE
Practice Address - State:TX
Practice Address - Zip Code:78015-6514
Practice Address - Country:US
Practice Address - Phone:210-687-1280
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-10
Last Update Date:2013-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXC8442207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology