Healthcare Provider Details

I. General information

NPI: 1417181298
Provider Name (Legal Business Name): ANDREA R LOWDEN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/08/2009
Last Update Date: 07/02/2025
Certification Date: 07/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 E JOHN CARPENTER FWY
IRVING TX
75062-3955
US

IV. Provider business mailing address

777 BANNOCK ST
DENVER CO
80204-4597
US

V. Phone/Fax

Practice location:
  • Phone: 469-846-8322
  • Fax: 469-846-8323
Mailing address:
  • Phone: 303-436-4949
  • Fax: 303-436-6328

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberMT194723
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code2084N0402X
TaxonomyNeurology with Special Qualifications in Child Neurology Physician
License NumberCDR.0004321
License Number StateCO
# 3
Primary TaxonomyN
Taxonomy Code2084N0402X
TaxonomyNeurology with Special Qualifications in Child Neurology Physician
License NumberC2858
License Number StateKY
# 4
Primary TaxonomyN
Taxonomy Code2084N0402X
TaxonomyNeurology with Special Qualifications in Child Neurology Physician
License Number44002
License Number StateOK
# 5
Primary TaxonomyN
Taxonomy Code2084N0600X
TaxonomyClinical Neurophysiology Physician
License NumberC2858
License Number StateKY
# 6
Primary TaxonomyY
Taxonomy Code2084N0402X
TaxonomyNeurology with Special Qualifications in Child Neurology Physician
License NumberQ9421
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: