Provider Demographics
NPI:1467562736
Name:LOWERY, RAY KENTON (DC)
Entity Type:Individual
Prefix:DR
First Name:RAY
Middle Name:KENTON
Last Name:LOWERY
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 677
Mailing Address - Street 2:
Mailing Address - City:BRACKETTVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78832-0677
Mailing Address - Country:US
Mailing Address - Phone:830-765-4917
Mailing Address - Fax:830-563-6249
Practice Address - Street 1:401 W CANTU RD STE A
Practice Address - Street 2:
Practice Address - City:DEL RIO
Practice Address - State:TX
Practice Address - Zip Code:78840-3093
Practice Address - Country:US
Practice Address - Phone:830-775-7777
Practice Address - Fax:830-775-7777
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX9726111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX605224OtherBLUE CROSS
TX611043Medicare ID - Type Unspecified