Provider Demographics
NPI:1093452435
Name:LOW, DALLIN BRADY (MD)
Entity type:Individual
Prefix:
First Name:DALLIN
Middle Name:BRADY
Last Name:LOW
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:34 2 AVE W
Mailing Address - Street 2:
Mailing Address - City:CARDSTON
Mailing Address - State:ALBERTA
Mailing Address - Zip Code:T0K 0K0
Mailing Address - Country:CA
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:34 2 AVE W
Practice Address - Street 2:
Practice Address - City:CARDSTON
Practice Address - State:ALBERTA
Practice Address - Zip Code:T0K 0K0
Practice Address - Country:CA
Practice Address - Phone:403-653-3331
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-17
Last Update Date:2025-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXU7004207Q00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine