Provider Demographics
NPI:1558598490
Name:OWENS, ERIN MACDONALD (MD)
Entity Type:Individual
Prefix:DR
First Name:ERIN
Middle Name:MACDONALD
Last Name:OWENS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MISS
Other - First Name:ERIN
Other - Middle Name:LOUISE
Other - Last Name:MACDONALD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1701 N SENATE BLVD # B401
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46202-1239
Mailing Address - Country:US
Mailing Address - Phone:214-450-5001
Mailing Address - Fax:
Practice Address - Street 1:1701 N SENATE BLVD # B401
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46202-1239
Practice Address - Country:US
Practice Address - Phone:214-450-5001
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-06-18
Last Update Date:2013-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
TXP1911207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX301351801Medicaid
TXP01121125OtherRRMCARE (AEMA)
TX301351802Medicaid
TXTXB156607Medicare PIN
TXP01121125OtherRRMCARE (AEMA)