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NPI Code Detail

MEDICARE: MRS. TARA DIONNE OWENS FNP-C

MEDICARE: MRS. TARA DIONNE OWENS FNP-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse PractitionerAP126753TX

General Provider Information

NPI Number : 1477942787
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. TARA DIONNE OWENS FNP-C
Provider Business Mailing Address
First Line : 1335 GRANT ST
Second Line :
City : BEAUMONT
State : TX
Zip : 77701-6324
Country : US
Telephone Number : 409-338-8186
Fax Number :
Provider Business Practice Location Address
First Line : 2950 NORTH LOOP W STE 500
Second Line :
City : HOUSTON
State : TX
Zip : 77092-8830
Country : US
Telephone Number : 832-786-4970
Fax Number : 855-722-0157
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/12/2015
Last Update Date : 01/12/2015

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