Provider Demographics
NPI:1669477709
Name:OWEN, KAYE KIP (MD)
Entity Type:Individual
Prefix:DR
First Name:KAYE
Middle Name:KIP
Last Name:OWEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:KAYE
Other - Middle Name:KIP
Other - Last Name:OWEN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 4624
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78502-4624
Mailing Address - Country:US
Mailing Address - Phone:956-362-6683
Mailing Address - Fax:956-362-6809
Practice Address - Street 1:5540 RAPHAEL DR
Practice Address - Street 2:
Practice Address - City:EDINBURG
Practice Address - State:TX
Practice Address - Zip Code:78539-1407
Practice Address - Country:US
Practice Address - Phone:956-362-6683
Practice Address - Fax:956-362-6809
Is Sole Proprietor?:No
Enumeration Date:2005-06-16
Last Update Date:2023-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH6491207X00000X, 207XX0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports Medicine
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
5903260OtherAETNA
TX152741804Medicaid
TXDC6602OtherMEDICARE RAILROAD
106164100OtherDEPT. OF LABOR
TX0075KWOtherBCBS
0900894OtherUNITED HEALTHCARE
TX123584OtherCHIPS
129930101OtherVALLEY HEALTH PLAN
0900894OtherUNITED HEALTHCARE
TXDC6602OtherMEDICARE RAILROAD