Jerry Bryan Owen D.O

NPI 1073591350 - Preventive Medicine - 2083P0500X

NPI Details
NPI 1073591350
Gender Male
Enumeration Date 01/06/2006
Last Updated 07/09/2007
Entity Type Individual
Active Over 10 years ago
Practice Location
2200 BERGQUIST DR, SUITE 1
ATTN: CREDENTIALS (CMC)
LACKLAND AFB TX, 78236-5300, US
Phone (210) 292-6002
Fax (210) 292-7964
Business Location
8312 TRACINEY BLVD
SAN ANTONIO TX, 78255-3536, US
Phone (210) 698-1375
Fax
Toxanomy
Taxonomy Code 2083P0500X
License State Texas
License Number F7019
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According to our database, Dr. Jerry Bryan Owen D.O NPI is 1073591350, taxonomy code is 2083P0500X and license number is F7019, license state is located at Texas. Jerry Bryan Owen D.O physically located at 2200 Bergquist Dr, Suite 1, Lackland Afb TX, 78236-5300. NPI Number Jerry Bryan Owen D.O has the Individual type.

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1073591350 NPI number is provided on an as is basis without warranty of any kind. 1073591350 is maintained by the National Plan & Provider Enumeration System. The contents of Jerry Bryan Owen D.O are for informational purposes only.