Provider Demographics
NPI:1366439556
Name:LOWE, GERALD HOWARD (LCSW)
Entity Type:Individual
Prefix:MR
First Name:GERALD
Middle Name:HOWARD
Last Name:LOWE
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1007 MOPAC CIRCLE
Mailing Address - Street 2:102
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78746-6807
Mailing Address - Country:US
Mailing Address - Phone:512-330-9952
Mailing Address - Fax:512-327-5525
Practice Address - Street 1:1007 MOPAC CIRCLE
Practice Address - Street 2:102
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78746-6807
Practice Address - Country:US
Practice Address - Phone:512-330-9952
Practice Address - Fax:512-327-5525
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-03
Last Update Date:2008-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX091091041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXOOS79YMedicare ID - Type Unspecified