MEDICARE: DR. LOWELL T. KU M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207V00000X	Obstetrics & Gynecology Physician	L1099	TX
2	207VE0102X	Reproductive Endocrinology Physician	L1099	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	L1099	OTHER	TX	STATE LICENCE

General Provider Information

NPI Number	:	1184642274
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LOWELL T. KU M.D.

Provider Business Mailing Address
First Line	:	2840 LEGACY DR
Second Line	:	SUITE 100
City	:	FRISCO
State	:	TX
Zip	:	75034-6049
Country	:	US
Telephone Number	:	214-297-0020
Fax Number	:	214-297-0025

Provider Business Practice Location Address
First Line	:	2840 LEGACY DR
Second Line	:	SUITE 100
City	:	FRISCO
State	:	TX
Zip	:	75034-6049
Country	:	US
Telephone Number	:	214-297-0020
Fax Number	:	214-297-0025

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/17/2006
Last Update Date	:	08/17/2012

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Directions to “ DR. LOWELL T. KU M.D.” Practice Location

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