Provider Demographics
NPI:1083755284
Name:LOWRY, ANDREW B (MD)
Entity Type:Individual
Prefix:
First Name:ANDREW
Middle Name:B
Last Name:LOWRY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
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Mailing Address - Street 1:2200 W SPRING CREEK PKWY
Mailing Address - Street 2:SUITE B
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75023-4184
Mailing Address - Country:US
Mailing Address - Phone:972-599-1314
Mailing Address - Fax:972-599-1227
Practice Address - Street 1:2200 W SPRING CREEK PKWY
Practice Address - Street 2:SUITE B
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75023-4184
Practice Address - Country:US
Practice Address - Phone:972-599-1314
Practice Address - Fax:972-599-1227
Is Sole Proprietor?:No
Enumeration Date:2007-02-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXE6839207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX041874101Medicaid
TX041874101Medicaid
TXB24490Medicare UPIN