Provider Demographics
NPI:1346504073
Name:KETRON, LOWELL LANE (MD)
Entity Type:Individual
Prefix:DR
First Name:LOWELL
Middle Name:LANE
Last Name:KETRON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:100 MEDICAL CENTER BLVD STE 200
Mailing Address - Street 2:
Mailing Address - City:CONROE
Mailing Address - State:TX
Mailing Address - Zip Code:77304-2821
Mailing Address - Country:US
Mailing Address - Phone:936-441-9680
Mailing Address - Fax:936-539-9685
Practice Address - Street 1:100 MEDICAL CENTER BLVD STE 200
Practice Address - Street 2:
Practice Address - City:CONROE
Practice Address - State:TX
Practice Address - Zip Code:77304-2821
Practice Address - Country:US
Practice Address - Phone:936-441-9680
Practice Address - Fax:936-539-9685
Is Sole Proprietor?:No
Enumeration Date:2012-06-27
Last Update Date:2020-11-12
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXS6423207RC0000X, 207RI0011X, 207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease