Provider Demographics
NPI:1215013271
Name:OWENSBY, LOREN C (MD)
Entity Type:Individual
Prefix:DR
First Name:LOREN
Middle Name:C
Last Name:OWENSBY
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 1:601 E SAN ANTONIO ST
Mailing Address - Street 2:SUITE 305
Mailing Address - City:VICTORIA
Mailing Address - State:TX
Mailing Address - Zip Code:77901-6040
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:601 E SAN ANTONIO ST
Practice Address - Street 2:SUITE 305
Practice Address - City:VICTORIA
Practice Address - State:TX
Practice Address - Zip Code:77901-6040
Practice Address - Country:US
Practice Address - Phone:361-578-0324
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-31
Last Update Date:2013-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXE8095207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX035325201Medicaid
TXB25332Medicare UPIN
TX00PC38Medicare ID - Type Unspecified