Provider Demographics
NPI:1194735787
Name:OWEN, STUART FREDERICK (MD)
Entity type:Individual
Prefix:DR
First Name:STUART
Middle Name:FREDERICK
Last Name:OWEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3600 GASTON AVE STE 1004
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75246-1810
Mailing Address - Country:US
Mailing Address - Phone:214-827-7600
Mailing Address - Fax:214-827-0076
Practice Address - Street 1:3600 GASTON AVE STE 1004
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75246-1810
Practice Address - Country:US
Practice Address - Phone:214-827-7600
Practice Address - Fax:214-827-0076
Is Sole Proprietor?:No
Enumeration Date:2006-08-08
Last Update Date:2022-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF7020207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX824815Medicare ID - Type Unspecified
TXC20098Medicare UPIN
TXC20098Medicare UPIN