Healthcare Provider Details

I. General information

NPI: 1992816292
Provider Name (Legal Business Name): BRIAN OWENS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/31/2006
Last Update Date: 07/01/2020
Certification Date: 07/01/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1105 UNIVERSITY DR E STE C102
COLLEGE STATION TX
77840-2183
US

IV. Provider business mailing address

1105 UNIVERSITY DR E STE C102
COLLEGE STATION TX
77840-2183
US

V. Phone/Fax

Practice location:
  • Phone: 979-485-2966
  • Fax: 979-704-6392
Mailing address:
  • Phone: 979-485-2966
  • Fax: 979-776-0588

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberL8873
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License NumberL8873
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: