Provider Demographics
NPI:1194225086
Name:OWEN, JANET KAY
Entity Type:Individual
Prefix:
First Name:JANET
Middle Name:KAY
Last Name:OWEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1902 STONEHENGE CV
Mailing Address - Street 2:
Mailing Address - City:CEDAR PARK
Mailing Address - State:TX
Mailing Address - Zip Code:78613-6821
Mailing Address - Country:US
Mailing Address - Phone:512-698-2249
Mailing Address - Fax:
Practice Address - Street 1:1902 STONEHENGE CV
Practice Address - Street 2:
Practice Address - City:CEDAR PARK
Practice Address - State:TX
Practice Address - Zip Code:78613-6821
Practice Address - Country:US
Practice Address - Phone:512-698-2249
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-02-16
Last Update Date:2018-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX3747P1801XMedicaid