Provider Demographics
NPI:1538294913
Name:LOWRANCE, CHRISTY THERIOT (PA)
Entity Type:Individual
Prefix:
First Name:CHRISTY
Middle Name:THERIOT
Last Name:LOWRANCE
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2680 MCFADDIN ST
Mailing Address - Street 2:
Mailing Address - City:BEAUMONT
Mailing Address - State:TX
Mailing Address - Zip Code:77702-1621
Mailing Address - Country:US
Mailing Address - Phone:409-835-2112
Mailing Address - Fax:409-839-8988
Practice Address - Street 1:2680 MCFADDIN ST
Practice Address - Street 2:
Practice Address - City:BEAUMONT
Practice Address - State:TX
Practice Address - Zip Code:77702-1621
Practice Address - Country:US
Practice Address - Phone:409-835-2112
Practice Address - Fax:409-839-8988
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-23
Last Update Date:2008-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA03820207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease