Healthcare Provider Details

I. General information

NPI: 1699712703
Provider Name (Legal Business Name): RICHARD WILLIAM LOWRY M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/31/2006
Last Update Date: 01/21/2025
Certification Date: 01/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1783 TROUP HWY
TYLER TX
75701-5869
US

IV. Provider business mailing address

1783 TROUP HWY
TYLER TX
75701-5869
US

V. Phone/Fax

Practice location:
  • Phone: 903-595-2283
  • Fax: 903-595-1063
Mailing address:
  • Phone: 903-595-2283
  • Fax: 903-595-1063

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License NumberH8733
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberH8733
License Number StateTX
# 3
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number19048
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: