Provider Demographics
NPI:1467543561
Name:THOMAS D LOWE, OD PC
Entity Type:Organization
Organization Name:THOMAS D LOWE, OD PC
Other - Org Name:MODERN EYE CARE DBA
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT OPTOMETRIST
Authorized Official - Prefix:MR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:D
Authorized Official - Last Name:LOWE
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:319-653-2371
Mailing Address - Street 1:301 S IOWA AVE
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:IA
Mailing Address - Zip Code:52353-1747
Mailing Address - Country:US
Mailing Address - Phone:319-653-2371
Mailing Address - Fax:319-653-6070
Practice Address - Street 1:301 S IOWA AVE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:IA
Practice Address - Zip Code:52353-1747
Practice Address - Country:US
Practice Address - Phone:319-653-2371
Practice Address - Fax:319-653-6070
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MODERN EYE CARE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-09-27
Last Update Date:2009-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA1659152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0454380001Medicare NSC
IAT00890Medicare UPIN
IAU96194Medicare UPIN