Provider Demographics
NPI:1093767436
Name:OWEN, CHARLES B II (MD)
Entity Type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:B
Last Name:OWEN
Suffix:II
Gender:M
Credentials:MD
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Mailing Address - Street 1:3403 FOOTHILL PKWY
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78731-5824
Mailing Address - Country:US
Mailing Address - Phone:512-451-9606
Mailing Address - Fax:512-451-7221
Practice Address - Street 1:3403 FOOTHILL PKWY
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78731-5824
Practice Address - Country:US
Practice Address - Phone:512-451-9606
Practice Address - Fax:512-451-7221
Is Sole Proprietor?:No
Enumeration Date:2006-05-16
Last Update Date:2023-04-10
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXF7017207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX137689914Medicaid
TXF7017OtherSTATE MEDICAL LICENSE
81821B8Medicare ID - Type Unspecified
TX137689914Medicaid