Basic Information
| Provider Information | |||||||||
| NPI: | 1205062262 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | OWENS | ||||||||
| FirstName: | KRISTIN | ||||||||
| MiddleName: | MARIE BERG | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1140 BUSINESS CENTER DRIVE | ||||||||
| Address2: | STE. 201 | ||||||||
| City: | HOUSTON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 770432744 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7139325757 | ||||||||
| FaxNumber: | 7139325750 | ||||||||
| Practice Location | |||||||||
| Address1: | 921 GESSNER RD | ||||||||
| Address2: | |||||||||
| City: | HOUSTON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 770242501 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7132423000 | ||||||||
| FaxNumber: | 7344639298 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/04/2009 | ||||||||
| LastUpdateDate: | 11/13/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 11/13/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 390200000X | MI | N | Student, Health Care | Student in an Organized Health Care Education/Training Program | 207P00000X | P6337 | TX | Y | Allopathic & Osteopathic Physicians | Emergency Medicine |
No ID Information.