Provider Demographics
NPI:1093048803
Name:OWSLEY, ROBERT LAMAR (DDS)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:LAMAR
Last Name:OWSLEY
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 HAMPER CT
Mailing Address - Street 2:
Mailing Address - City:TROPHY CLUB
Mailing Address - State:TX
Mailing Address - Zip Code:76262-5570
Mailing Address - Country:US
Mailing Address - Phone:817-239-7171
Mailing Address - Fax:817-491-5998
Practice Address - Street 1:1 HAMPER CT
Practice Address - Street 2:
Practice Address - City:TROPHY CLUB
Practice Address - State:TX
Practice Address - Zip Code:76262-5570
Practice Address - Country:US
Practice Address - Phone:817-239-7171
Practice Address - Fax:817-491-5998
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-10
Last Update Date:2009-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX126101223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice