Provider Demographics
NPI:1659915254
Name:O&W SURGICAL PLLC
Entity Type:Organization
Organization Name:O&W SURGICAL PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE MBR/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CHAD
Authorized Official - Middle Name:E
Authorized Official - Last Name:LEWIS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:806-452-7221
Mailing Address - Street 1:2200 4TH AVENUE
Mailing Address - Street 2:#207
Mailing Address - City:CANYON
Mailing Address - State:TX
Mailing Address - Zip Code:79015-4030
Mailing Address - Country:US
Mailing Address - Phone:806-452-7221
Mailing Address - Fax:806-452-7231
Practice Address - Street 1:1617 4TH AVE
Practice Address - Street 2:
Practice Address - City:CANYON
Practice Address - State:TX
Practice Address - Zip Code:79015-3824
Practice Address - Country:US
Practice Address - Phone:806-452-7221
Practice Address - Fax:806-452-7231
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-11-06
Last Update Date:2020-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208C00000XAllopathic & Osteopathic PhysiciansColon & Rectal SurgeryGroup - Single Specialty