Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2084N0402X | Child Neurologist | F9908 | TX |
NPI | 1386621365 |
---|---|
Provider Name | David B Owen |
First Address | Dallas, TX 75230-2507 |
Second Address | Dallas, TX 75230-2507 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/12/2005 |
Last Update Date | 11/01/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
E79494 | (02) |