Lowry, Jefferson Roy
Lowry, Jefferson Roy is an sole proprietor health care provider with primary practice located at 1250 8Th Ave Suite 135, Fort Worth TX 76104. He recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Oral & Maxillofacial Surgery, Allopathic & Osteopathic Physicians / Otolaryngology, Allopathic & Osteopathic Physicians / Pediatric Otolaryngology. Allopathic & Osteopathic Physicians / Otolaryngology is his primary health care specialty. Lowry, Jefferson Roy can be contacted via phone (817) 335-8151.Contact Information
Primary practice address
1250 8Th Ave Suite 135
Fort Worth TX 76104
Phone: (817) 335-8151
Fax: (817) 335-2670
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Oral & Maxillofacial Surgery | 204E00000X | F0567 | Texas |
| Allopathic & Osteopathic Physicians / Otolaryngology | 207Y00000X | F0567 | Texas |
| Allopathic & Osteopathic Physicians / Pediatric Otolaryngology | 207YP0228X | F0567 | Texas |
Profile Details
| NPI number | 1790758563 |
|---|---|
| LBN Legal business name | Lowry, Jefferson Roy |
| Credentials | Doctor of Osteopathy (DO) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Feb 10th, 2006 |
| Last updated | Apr 9th, 2014 - about 10 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1790758563 | NPPES |
| Texas | Other | 760330807 | TAX ID |
| Texas | Other | PR29609650002 | TAX ID |
| Texas | Other | 2940798 | TAX ID |
| Texas | Other | 00000074EP | TAX ID |
| Texas | MEDICAID | 0310740-01 | TAX ID |
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