Healthcare Provider Details
I. General information
NPI: 1609856772
Provider Name (Legal Business Name): JAMES L OWNBEY MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 01/17/2006
Last Update Date: 06/18/2015
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3615 19TH ST
LUBBOCK TX
79410-1203
US
IV. Provider business mailing address
14275 MIDWAY RD SUITE 400
ADDISON TX
75001-3614
US
V. Phone/Fax
- Phone: 806-744-1887
- Fax: 806-744-5545
- Phone:
- Fax: 610-271-4245
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207ZP0102X |
| Taxonomy | Anatomic Pathology & Clinical Pathology Physician |
| License Number | E2771 |
| License Number State | TX |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: