Healthcare Provider Details

I. General information

NPI: 1649209636
Provider Name (Legal Business Name): TERRY W. LOWRY MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/02/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1151 S LA CANADA DR
GREEN VALLEY AZ
85614-1943
US

IV. Provider business mailing address

655 N ALVERNON WAY SUITE 216
TUCSON AZ
85711-1823
US

V. Phone/Fax

Practice location:
  • Phone: 520-625-3230
  • Fax: 520-625-9162
Mailing address:
  • Phone: 520-547-4906
  • Fax: 520-795-0225

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number15838
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: