MEDICARE: PATRICIA LOWRIMORE 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	2084P0800X	Psychiatry Physician	L5030	TX

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	P00432976	OTHER	TX	MEDICARE RAILROAD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	8AE790	OTHER	TX	BCBS
3	1831194455	OTHER	TX	NPI INDIVIDUAL

General Provider Information

NPI Number	:	1831194455
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PATRICIA LOWRIMORE M.D.

Provider Business Mailing Address
First Line	:	PO BOX 99335
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76199-0335
Country	:	US
Telephone Number	:	817-702-4781
Fax Number	:	817-702-8438

Provider Business Practice Location Address
First Line	:	855 MONTGOMERY ST
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76107-2553
Country	:	US
Telephone Number	:	817-702-4781
Fax Number	:	817-702-8438

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

Provider Enumeration Date	:	06/20/2005
Last Update Date	:	05/05/2016

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