Provider Demographics
NPI:1710278585
Name:KEVIN J OWENS
Entity Type:Organization
Organization Name:KEVIN J OWENS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:J
Authorized Official - Last Name:OWENS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:512-446-4502
Mailing Address - Street 1:209 WATERSONG LN
Mailing Address - Street 2:
Mailing Address - City:GEORGETOWN
Mailing Address - State:TX
Mailing Address - Zip Code:78628-6954
Mailing Address - Country:US
Mailing Address - Phone:512-446-4502
Mailing Address - Fax:512-446-0084
Practice Address - Street 1:2401 FM 646 RD W
Practice Address - Street 2:SUITE B
Practice Address - City:DICKINSON
Practice Address - State:TX
Practice Address - Zip Code:77539-3249
Practice Address - Country:US
Practice Address - Phone:512-446-4502
Practice Address - Fax:512-446-0084
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-27
Last Update Date:2011-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes293D00000XLaboratoriesPhysiological Laboratory