Provider Demographics
NPI:1760667133
Name:LOWRY, LARRY (DO)
Entity Type:Individual
Prefix:DR
First Name:LARRY
Middle Name:
Last Name:LOWRY
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:208 SANDZEN DR
Mailing Address - Street 2:
Mailing Address - City:CLOVIS
Mailing Address - State:NM
Mailing Address - Zip Code:88101-2310
Mailing Address - Country:US
Mailing Address - Phone:575-762-6411
Mailing Address - Fax:
Practice Address - Street 1:208 SANDZEN DR
Practice Address - Street 2:
Practice Address - City:CLOVIS
Practice Address - State:NM
Practice Address - Zip Code:88101-2310
Practice Address - Country:US
Practice Address - Phone:575-762-6411
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-04
Last Update Date:2008-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMA519207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine