Provider Demographics
NPI:1952894362
Name:OWENS, ALLYSON (DO)
Entity Type:Individual
Prefix:DR
First Name:ALLYSON
Middle Name:
Last Name:OWENS
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18511 HIGHLANDER MEDICS ST
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79906-5327
Mailing Address - Country:US
Mailing Address - Phone:915-742-0450
Mailing Address - Fax:
Practice Address - Street 1:WBAMC/DOM/GME
Practice Address - Street 2:18511 HIGHLANDER MEDICS STREET
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79918
Practice Address - Country:US
Practice Address - Phone:915-742-0450
Practice Address - Fax:915-742-4363
Is Sole Proprietor?:No
Enumeration Date:2018-06-11
Last Update Date:2021-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
NE2197207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program