Provider Demographics
NPI:1811309651
Name:TANO, LOWELL
Entity type:Individual
Prefix:
First Name:LOWELL
Middle Name:
Last Name:TANO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10450 BRIAN MOONEY AVE
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79935-2809
Mailing Address - Country:US
Mailing Address - Phone:915-598-6616
Mailing Address - Fax:915-598-6651
Practice Address - Street 1:10450 BRIAN MOONEY AVE
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79935-2809
Practice Address - Country:US
Practice Address - Phone:915-598-6616
Practice Address - Fax:915-598-6651
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-28
Last Update Date:2024-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist