Provider Demographics
NPI:1336304435
Name:OWEN, WILLIAM EARL JR (PT, DPT, FAAOMPT)
Entity Type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:EARL
Last Name:OWEN
Suffix:JR
Gender:M
Credentials:PT, DPT, FAAOMPT
Other - Prefix:MR
Other - First Name:BILL
Other - Middle Name:EARL
Other - Last Name:OWEN
Other - Suffix:JR
Other - Last Name Type:Other Name
Other - Credentials:PT
Mailing Address - Street 1:5313 DECKER DR
Mailing Address - Street 2:
Mailing Address - City:BAYTOWN
Mailing Address - State:TX
Mailing Address - Zip Code:77520-1413
Mailing Address - Country:US
Mailing Address - Phone:281-838-4477
Mailing Address - Fax:281-838-3465
Practice Address - Street 1:5313 DECKER DR
Practice Address - Street 2:
Practice Address - City:BAYTOWN
Practice Address - State:TX
Practice Address - Zip Code:77520-1413
Practice Address - Country:US
Practice Address - Phone:281-838-4477
Practice Address - Fax:281-838-3465
Is Sole Proprietor?:No
Enumeration Date:2008-07-28
Last Update Date:2021-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1052439225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX378061101Medicaid