MEDICARE: DR. JACK HUNTER OWEN D. 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
1	111N00000X	Chiropractor	8629	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	8H1250	OTHER	TX	BLUE CROSS BLUE SHIELD

General Provider Information

NPI Number	:	1669577789
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JACK HUNTER OWEN D. C.

Provider Business Mailing Address
First Line	:	7739 NORTHCROSS DR
Second Line	:	SUITE J
City	:	AUSTIN
State	:	TX
Zip	:	78757-1700
Country	:	US
Telephone Number	:	512-451-9655
Fax Number	:	512-380-9599

Provider Business Practice Location Address
First Line	:	7739 NORTHCROSS DR
Second Line	:	SUITE J
City	:	AUSTIN
State	:	TX
Zip	:	78757-1700
Country	:	US
Telephone Number	:	512-451-9655
Fax Number	:	512-380-9599

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/13/2006
Last Update Date	:	07/09/2009

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