Provider Demographics
NPI:1477658326
Name:LOWRY, ROBERT C (MD)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:C
Last Name:LOWRY
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 1:2425 BABCOCK RD
Mailing Address - Street 2:SUITE 111
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78229-4898
Mailing Address - Country:US
Mailing Address - Phone:210-558-0991
Mailing Address - Fax:210-558-0520
Practice Address - Street 1:7355 BARLITE BLVD
Practice Address - Street 2:SUITE 101
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78224-1342
Practice Address - Country:US
Practice Address - Phone:210-333-1477
Practice Address - Fax:210-927-7601
Is Sole Proprietor?:No
Enumeration Date:2006-09-14
Last Update Date:2011-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ9179208100000X, 208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8B0150OtherBC/BS OF TEXAS
TX131296907Medicaid
TX8B0150OtherBC/BS OF TEXAS
8J7838Medicare PIN