Provider Demographics
NPI:1922399443
Name:LOWREY, RANDY (ATP)
Entity Type:Individual
Prefix:MR
First Name:RANDY
Middle Name:
Last Name:LOWREY
Suffix:
Gender:M
Credentials:ATP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5301 BOSQUE BLVD STE 330
Mailing Address - Street 2:
Mailing Address - City:WACO
Mailing Address - State:TX
Mailing Address - Zip Code:76710-4401
Mailing Address - Country:US
Mailing Address - Phone:254-751-1131
Mailing Address - Fax:254-751-1977
Practice Address - Street 1:5301 BOSQUE BLVD STE 330
Practice Address - Street 2:
Practice Address - City:WACO
Practice Address - State:TX
Practice Address - Zip Code:76710-4401
Practice Address - Country:US
Practice Address - Phone:254-751-1131
Practice Address - Fax:254-751-1977
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-02
Last Update Date:2011-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other