Provider Demographics
NPI:1831314376
Name:OWEN, CHAD COURTNEY (DC)
Entity Type:Individual
Prefix:DR
First Name:CHAD
Middle Name:COURTNEY
Last Name:OWEN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7071C SAN PEDRO AVE
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78216-6209
Mailing Address - Country:US
Mailing Address - Phone:210-342-1356
Mailing Address - Fax:210-342-5052
Practice Address - Street 1:7071C SAN PEDRO AVE
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78216-6209
Practice Address - Country:US
Practice Address - Phone:210-342-1356
Practice Address - Fax:210-342-5052
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX9188111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor