Provider Demographics
NPI:1639574817
Name:LOWRIE, MYRA (MA, IBCLC)
Entity Type:Individual
Prefix:
First Name:MYRA
Middle Name:
Last Name:LOWRIE
Suffix:
Gender:F
Credentials:MA, IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9615 NEW KENT DR
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77498-1039
Mailing Address - Country:US
Mailing Address - Phone:281-495-7639
Mailing Address - Fax:
Practice Address - Street 1:9615 NEW KENT DR
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77498-1039
Practice Address - Country:US
Practice Address - Phone:281-495-7639
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-29
Last Update Date:2014-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL-23919174N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RN