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General NPI Number Information
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NPI Number | 1891374492
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Entity Type | Individual
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Provider Name | JUSTIN THOMAS OWENS D.O.
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Gender | Male
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Dates
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Enumeration Date | 04/02/2021
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Last Update Date | 07/29/2025
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Provider Practice Location Address
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Address Line | 5632 EDWARDS RANCH RD STE 100
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City | FORT WORTH
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State | TX
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Zip | 76109-4149
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Country | US
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Telephone | 817-336-7188
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Fax | 844-231-8865
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Provider Business Mailing Address
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Address Line | 5632 EDWARDS RANCH RD STE 100
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City | FORT WORTH
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State | TX
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Zip | 76109-4149
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Country | US
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Telephone | 817-336-7188
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Fax | 844-231-8865
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | V7602
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License Number State | TX
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