1750604690 NPI number — OWEN OSAGIE, MD,PA

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1750604690 NPI number — OWEN OSAGIE, MD,PA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
OWEN OSAGIE, MD,PA
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1750604690
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/07/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4122 FOXBRUSH LN
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SUGAR LAND
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
77479-5294
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
281-565-3993
Provider Business Mailing Address Fax Number:
281-232-4312

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4910 AIRPORT AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ROSENBERG
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77471-5759
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
281-239-1306
Provider Business Practice Location Address Fax Number:
281-232-4312
Provider Enumeration Date:
03/07/2010

Additional Information

Authorized Official

Authorized Official Last Name:
OSAGIE
Authorized Official First Name:
OWEN
Authorized Official Middle Name:
OSAMOGIE
Authorized Official Title or Position:
DOCTOR
Authorized Official Telephone Number:
281-565-3993

Provider Taxonomy Codes

  • Taxonomy code: 2084P0800X , with the licence number:  K0971 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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