Organization
PRO-ACTIVE NEUROLOGY & SPORTS REHAB
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT C LOWRY M.D. (OWNER)
(210) 333-1477
Entity
Organization
Contact information
Practice address
7355 BARLITE BLVD STE 101, SAN ANTONIO, TX 78224-1340
(210) 333-1477
(210) 558-0520
Mailing address
7355 BARLITE BLVD STE 101, SAN ANTONIO, TX 78224-1340
(210) 333-1477
(210) 558-0520
Taxonomy
Speciality
Code
Description
License number
State
305R00000X
Preferred Provider Organization
Primary
J9179
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
131296907
—
TX
Enumeration date
10/26/2015
Last updated
10/26/2015
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