Provider Demographics
NPI:1497700199
Name:OWO, TOKS (MD)
Entity Type:Individual
Prefix:DR
First Name:TOKS
Middle Name:
Last Name:OWO
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 1:2330 MONTGOMERY PARK BLVD
Mailing Address - Street 2:STE 824
Mailing Address - City:CONROE
Mailing Address - State:TX
Mailing Address - Zip Code:77304-3611
Mailing Address - Country:US
Mailing Address - Phone:940-300-7514
Mailing Address - Fax:
Practice Address - Street 1:110 MEMORIAL HOSPITAL DR
Practice Address - Street 2:EMERGENCY DEPARTMENT, HUNTSVILLE MEMORIAL HOSPITAL
Practice Address - City:HUNTSVILLE
Practice Address - State:TX
Practice Address - Zip Code:77340-4940
Practice Address - Country:US
Practice Address - Phone:936-291-4589
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL0477207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
F28777Medicare UPIN