Provider Demographics
NPI:1336304435
Name:OWEN, WILLIAM EARL JR (PT, DPT, FAAOMPT)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:EARL
Last Name:OWEN
Suffix:JR
Gender:M
Credentials:PT, DPT, FAAOMPT
Other - Prefix:DR
Other - First Name:BILL
Other - Middle Name:EARL
Other - Last Name:OWEN
Other - Suffix:JR
Other - Last Name Type:Other Name
Other - Credentials:PT, DPT, FAAOMPT
Mailing Address - Street 1:616 MARRIOTT DR
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37214-5048
Mailing Address - Country:US
Mailing Address - Phone:629-802-3000
Mailing Address - Fax:
Practice Address - Street 1:10100 KATY FWY STE 170
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77043-5268
Practice Address - Country:US
Practice Address - Phone:832-795-9175
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-07-28
Last Update Date:2024-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1052439225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX378061101Medicaid