Healthcare Provider Details

I. General information

NPI: 1841800240
Provider Name (Legal Business Name): MONICA WEBSTER LOWE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/31/2020
Last Update Date: 07/31/2020
Certification Date: 07/31/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2709 MEADOW ISLE LN
DALLAS TX
75237-3215
US

IV. Provider business mailing address

5427 WHISPER GLEN DR
ARLINGTON TX
76017-6112
US

V. Phone/Fax

Practice location:
  • Phone: 214-298-3887
  • Fax:
Mailing address:
  • Phone: 317-508-6907
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code172A00000X
TaxonomyDriver
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: