Provider Demographics
NPI:1285775635
Name:A LOWRY & PLANO MEDICAL ASSOCIATES
Entity type:Organization
Organization Name:A LOWRY & PLANO MEDICAL ASSOCIATES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:W
Authorized Official - Last Name:TIDMORE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-596-7255
Mailing Address - Street 1:2200 W SPRING CREEK PARKWAY
Mailing Address - Street 2:SUITE B
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75023-4500
Mailing Address - Country:US
Mailing Address - Phone:972-599-1314
Mailing Address - Fax:972-599-1227
Practice Address - Street 1:2200 W SPRING CREEK PARKWAY
Practice Address - Street 2:SUITE B
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75023-4500
Practice Address - Country:US
Practice Address - Phone:972-599-1314
Practice Address - Fax:972-599-1227
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-09
Last Update Date:2011-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX041872501Medicaid
TX00J362OtherBCBS
TX041872501Medicaid