Organization
OWEN C. DEWITT, MD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
OWEN C. DEWITT MD (OWNER/PROVIDER)
(817) 336-1071
Entity
Organization
Contact information
Practice address
1307 8TH AVE STE 603, FORT WORTH, TX 76104-4142
(817) 336-1071
(817) 546-8681
Mailing address
PO BOX 11128, FORT WORTH, TX 76110-0128
(817) 336-1071
(817) 546-8681
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
G3287
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DD3512
RAILROAD MEDICARE
TX
Enumeration date
10/29/2007
Last updated
02/22/2008
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