# LAKE TEXANA FAMILY DENTISTRY

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1790257491
- **Authorized official:** DR. ERIC OWEN DDS (PRESIDENT)
- **Authorized official phone:** (361) 782-2223

## Contact information

- **Practice address:** 502 N WELLS ST, EDNA, TX 77957-2749
- **Practice address phone:** (361) 782-2223
- **Mailing address:** 502 N WELLS ST, EDNA, TX 77957-2749

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261Q00000X | Clinic/Center | — | NULL | — |
| 261QD0000X | Dental Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 12/19/2018
- **Last updated:** 08/28/2020