Provider Demographics
NPI:1669673224
Name:OWENS, ANDREW W (MD)
Entity type:Individual
Prefix:
First Name:ANDREW
Middle Name:W
Last Name:OWENS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2609 SCRIPTURE ST
Mailing Address - Street 2:
Mailing Address - City:DENTON
Mailing Address - State:TX
Mailing Address - Zip Code:76201-2302
Mailing Address - Country:US
Mailing Address - Phone:940-565-0800
Mailing Address - Fax:940-565-0884
Practice Address - Street 1:2609 SCRIPTURE ST
Practice Address - Street 2:
Practice Address - City:DENTON
Practice Address - State:TX
Practice Address - Zip Code:76201-2302
Practice Address - Country:US
Practice Address - Phone:940-565-0800
Practice Address - Fax:940-565-0884
Is Sole Proprietor?:No
Enumeration Date:2007-05-30
Last Update Date:2024-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN2705207RC0000X, 207RC0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0001XAllopathic & Osteopathic PhysiciansInternal MedicineClinical Cardiac Electrophysiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8CU880OtherBCBS INDIVIDUAL NUMBER
TX2817884-01Medicaid
BP1-0026388OtherINSTITUTIONAL PERMIT
TXTXB129347Medicare PIN
TX2817884-01Medicaid