Provider Demographics
NPI:1093570814
Name:DR PRISCILLA OWUSU MD PLLC
Entity Type:Organization
Organization Name:DR PRISCILLA OWUSU MD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PRISCILLA
Authorized Official - Middle Name:
Authorized Official - Last Name:OWUSU-FRIMPONG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-213-9595
Mailing Address - Street 1:11700 FM 423, STE 250
Mailing Address - Street 2:
Mailing Address - City:LITTLE ELM
Mailing Address - State:TX
Mailing Address - Zip Code:75068
Mailing Address - Country:US
Mailing Address - Phone:718-213-9595
Mailing Address - Fax:
Practice Address - Street 1:11700 FM 423, STE 250
Practice Address - Street 2:
Practice Address - City:LITTLE ELM
Practice Address - State:TX
Practice Address - Zip Code:75068
Practice Address - Country:US
Practice Address - Phone:718-213-9595
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-20
Last Update Date:2024-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty