Provider Demographics
NPI:1902882848
Name:LOWERY, JAMES DAVID (DO)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:DAVID
Last Name:LOWERY
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:811 NE ALSBURY BLVD
Mailing Address - Street 2:STE 800
Mailing Address - City:BURLESON
Mailing Address - State:TX
Mailing Address - Zip Code:76028-2668
Mailing Address - Country:US
Mailing Address - Phone:817-293-7311
Mailing Address - Fax:
Practice Address - Street 1:811 NE ALSBURY BLVD
Practice Address - Street 2:STE 800
Practice Address - City:BURLESON
Practice Address - State:TX
Practice Address - Zip Code:76028-2668
Practice Address - Country:US
Practice Address - Phone:817-293-7311
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-22
Last Update Date:2013-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK0515207P00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX88528KOtherBCBS
TX930076502OtherMEDICARE RAILROAD
TX133572105Medicaid
TX133572105Medicaid
TX88528KOtherBCBS