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General NPI Number Information
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NPI Number | 1831491653
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Entity Type | Organization
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Legal Business Name | JIMMY OWENS DDS PC
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Dates
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Enumeration Date | 11/30/2010
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Last Update Date | 11/30/2010
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Provider Practice Location Address
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Address Line | 2736 82ND ST
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City | LUBBOCK
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State | TX
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Zip | 79423-1428
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Country | US
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Telephone | 806-745-3381
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Fax | 806-745-3382
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Provider Business Mailing Address
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Address Line | 2736 82ND ST
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City | LUBBOCK
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State | TX
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Zip | 79423-1428
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Country | US
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Telephone | 806-745-3381
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Fax | 806-745-3382
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Authorized Official
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Title or Position | CEO
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Name | DR. JIMMY D OWENS
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Credential | DDS
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Telephone | 806-745-3381
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 11844
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License Number State | TX
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