Provider Demographics
NPI:1245661545
Name:OWENS, BARRY MATTHEW (ATC)
Entity type:Individual
Prefix:
First Name:BARRY
Middle Name:MATTHEW
Last Name:OWENS
Suffix:
Gender:M
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:801 LAURENCE DR
Mailing Address - Street 2:
Mailing Address - City:HEATH
Mailing Address - State:TX
Mailing Address - Zip Code:75032-1953
Mailing Address - Country:US
Mailing Address - Phone:469-698-2636
Mailing Address - Fax:469-698-2653
Practice Address - Street 1:801 LAURENCE DR
Practice Address - Street 2:
Practice Address - City:HEATH
Practice Address - State:TX
Practice Address - Zip Code:75032-1953
Practice Address - Country:US
Practice Address - Phone:469-698-2636
Practice Address - Fax:469-698-2653
Is Sole Proprietor?:Yes
Enumeration Date:2013-12-11
Last Update Date:2013-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX28182255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer