Healthcare Provider Details

I. General information

NPI: 1528230760
Provider Name (Legal Business Name): MR. SAMMY J OWINGS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/27/2008
Last Update Date: 03/27/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4622 34TH ST STE C
LUBBOCK TX
79410-2429
US

IV. Provider business mailing address

5405 86TH ST
LUBBOCK TX
79424-3505
US

V. Phone/Fax

Practice location:
  • Phone: 806-790-5634
  • Fax: 806-794-0125
Mailing address:
  • Phone: 806-790-5634
  • Fax: 806-794-0125

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332BN1400X
TaxonomyNursing Facility Supplies (DME)
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: