Provider Demographics
NPI:1497921266
Name:DAVID M OWENS
Entity Type:Organization
Organization Name:DAVID M OWENS
Other - Org Name:DAVID M OWENS
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:M
Authorized Official - Last Name:OWENS
Authorized Official - Suffix:
Authorized Official - Credentials:MD PA
Authorized Official - Phone:972-221-8588
Mailing Address - Street 1:571 W MAIN ST
Mailing Address - Street 2:200
Mailing Address - City:LEWISVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75057-3628
Mailing Address - Country:US
Mailing Address - Phone:972-221-8588
Mailing Address - Fax:972-221-8577
Practice Address - Street 1:571 W MAIN ST
Practice Address - Street 2:200
Practice Address - City:LEWISVILLE
Practice Address - State:TX
Practice Address - Zip Code:75057-3628
Practice Address - Country:US
Practice Address - Phone:972-221-8588
Practice Address - Fax:972-221-8577
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-01
Last Update Date:2008-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ2970207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX038406703Medicaid
TX00467VMedicare PIN
TX038406703Medicaid