Basic Information
| Provider Information | |||||||||
| NPI: | 1699784801 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | LOWE | ||||||||
| FirstName: | WILLIAM | ||||||||
| MiddleName: | DAVIS | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | P.O. BOX 961205 | ||||||||
| Address2: | |||||||||
| City: | FORT WORTH | ||||||||
| State: | TX | ||||||||
| PostalCode: | 761611205 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8177408400 | ||||||||
| FaxNumber: | 8173324465 | ||||||||
| Practice Location | |||||||||
| Address1: | 1651 W. ROSEDALE, SUITE 200 | ||||||||
| Address2: | |||||||||
| City: | FORT WORTH | ||||||||
| State: | TX | ||||||||
| PostalCode: | 761047437 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8173354316 | ||||||||
| FaxNumber: | 8173324465 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/05/2006 | ||||||||
| LastUpdateDate: | 03/16/2012 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207X00000X | H2543 | TX | Y | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | 207XS0106X | H2543 | TX | N | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | Hand Surgery |
ID Information
| ID | Type | State | Issuer | Description | 126594405 | 05 | TX | MEDICAID | P00941644 | 01 | TX | RAILROAD | OTHER | 126594406 | 05 | TX | MEDICAID |