MEDICARE: KIMCHAI LOWE DMD

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	122300000X	Dentist	122987	AK
2	1223G0001X	General Practice Dentistry	D11209	OR
3	1223G0001X	General Practice Dentistry	38076	TX
4	1223D0004X	Dental Anesthesiology	38076	TX

General Provider Information

NPI Number	:	1215457114
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KIMCHAI LOWE DMD

Provider Business Mailing Address
First Line	:	2162 SPRING STUEBNER RD
Second Line	:	STE 140 #3013
City	:	SPRING
State	:	TX
Zip	:	77389
Country	:	US
Telephone Number	:	713-855-3017
Fax Number	:

Provider Business Practice Location Address
First Line	:	9816 MEMORIAL BLVD STE 101
Second Line	:
City	:	HUMBLE
State	:	TX
Zip	:	77338-4205
Country	:	US
Telephone Number	:	281-446-6527
Fax Number	:

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

Provider Enumeration Date	:	06/21/2017
Last Update Date	:	09/04/2024

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