Provider Demographics
NPI:1639129265
Name:LOWRY, MADISON D (MD)
Entity Type:Individual
Prefix:
First Name:MADISON
Middle Name:D
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 1:1282 E COMMON ST
Mailing Address - Street 2:
Mailing Address - City:NEW BRAUNFELS
Mailing Address - State:TX
Mailing Address - Zip Code:78130-3509
Mailing Address - Country:US
Mailing Address - Phone:830-627-2200
Mailing Address - Fax:830-627-2203
Practice Address - Street 1:1282 E COMMON ST
Practice Address - Street 2:
Practice Address - City:NEW BRAUNFELS
Practice Address - State:TX
Practice Address - Zip Code:78130-3509
Practice Address - Country:US
Practice Address - Phone:830-627-2200
Practice Address - Fax:830-627-2203
Is Sole Proprietor?:No
Enumeration Date:2006-05-12
Last Update Date:2009-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK7448207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX029684004Medicaid
TX029684001Medicaid
TX029684004Medicaid
TXG98252Medicare UPIN