Provider Demographics
NPI:1528230760
Name:OWINGS, SAMMY J
Entity Type:Individual
Prefix:MR
First Name:SAMMY
Middle Name:J
Last Name:OWINGS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5405 86TH ST
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79424-3505
Mailing Address - Country:US
Mailing Address - Phone:806-790-5634
Mailing Address - Fax:806-794-0125
Practice Address - Street 1:4622 34TH ST STE C
Practice Address - Street 2:
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79410-2429
Practice Address - Country:US
Practice Address - Phone:806-790-5634
Practice Address - Fax:806-794-0125
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-27
Last Update Date:2008-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BN1400XSuppliersDurable Medical Equipment & Medical SuppliesNursing Facility Supplies
No332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0217370001Medicare PIN