Provider Demographics
NPI:1184642274
Name:KU, LOWELL T (MD)
Entity Type:Individual
Prefix:DR
First Name:LOWELL
Middle Name:T
Last Name:KU
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 1:2840 LEGACY DR
Mailing Address - Street 2:SUITE 100
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75034-6049
Mailing Address - Country:US
Mailing Address - Phone:214-297-0020
Mailing Address - Fax:214-297-0025
Practice Address - Street 1:2840 LEGACY DR
Practice Address - Street 2:SUITE 100
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75034-6049
Practice Address - Country:US
Practice Address - Phone:214-297-0020
Practice Address - Fax:214-297-0025
Is Sole Proprietor?:No
Enumeration Date:2006-07-17
Last Update Date:2012-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL1099207V00000X, 207VE0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VE0102XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyReproductive Endocrinology
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200521700Medicaid
KY64101439Medicaid
TXL1099OtherSTATE LICENCE
KY64101439Medicaid
KYH32249Medicare UPIN
TXL1099OtherSTATE LICENCE