Healthcare Provider Details

I. General information

NPI: 1699784801
Provider Name (Legal Business Name): WILLIAM DAVIS LOWE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/05/2006
Last Update Date: 03/16/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1651 W. ROSEDALE, SUITE 200
FORT WORTH TX
76104-7437
US

IV. Provider business mailing address

P.O. BOX 961205
FORT WORTH TX
76161-1205
US

V. Phone/Fax

Practice location:
  • Phone: 817-335-4316
  • Fax: 817-332-4465
Mailing address:
  • Phone: 817-740-8400
  • Fax: 817-332-4465

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberH2543
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code207XS0106X
TaxonomyOrthopaedic Hand Surgery Physician
License NumberH2543
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: