Provider Demographics
NPI:1235327800
Name:OVERN FAMILY MEDICINE, P.A.
Entity Type:Organization
Organization Name:OVERN FAMILY MEDICINE, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:PAUL
Authorized Official - Last Name:OVERN
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:972-548-0004
Mailing Address - Street 1:6210 VIRGINIA PKWY
Mailing Address - Street 2:
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75071-5504
Mailing Address - Country:US
Mailing Address - Phone:972-548-0004
Mailing Address - Fax:972-529-5099
Practice Address - Street 1:6210 VIRGINIA PKWY
Practice Address - Street 2:
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75071-5504
Practice Address - Country:US
Practice Address - Phone:972-548-0004
Practice Address - Fax:972-529-5099
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-09
Last Update Date:2007-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH5489207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXF10044Medicare UPIN