Active NPI
Samuel Craig Owen, M.D.
- Gastroenterology Physician
- San Antonio, TX
National Provider Identifier
1962761783
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gastroenterology Physician
- License
- 0101255392
- Practice address
- 3551 Roger Brooke Drive
Department of Gastroenterology
San Antonio, TX 78234 - Phone
- (210) 539-7074
- NPI assigned
- May 14, 2012
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 0101255392 | VA | |
| Gastroenterology Physician | 207RG0100X | 0101255392 | VA | Primary |
Addresses
Primary practice location
3551 Roger Brooke Drive
Department of Gastroenterology
San Antonio, TX 78234
Mailing address
3551 Roger Brooke Drive
Department of Gastroenterology
San Antonio, TX 78234
Phone (210) 539-7074
Other practice location 1
1100 Wilford Hall Loop
Jbsa Lackland, TX 78236-5638
Phone (210) 916-8166
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20140429000506 | TX | Order and Referring Only - Internal Medicine | 9931332970 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1336953600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1741305600000",
"number": "1962761783",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3551 ROGER BROOKE DRIVE",
"address_2": "DEPARTMENT OF GASTROENTEROLOGY",
"city": "SAN ANTONIO",
"state": "TX",
"postal_code": "78234",
"telephone_number": "210-539-7074"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3551 ROGER BROOKE DRIVE",
"address_2": "DEPARTMENT OF GASTROENTEROLOGY",
"city": "SAN ANTONIO",
"state": "TX",
"postal_code": "78234",
"telephone_number": "210-539-7074"
}
],
"practiceLocations": [
{
"address_1": "1100 Wilford Hall Loop",
"address_purpose": "LOCATION",
"city": "Jbsa Lackland",
"state": "TX",
"postal_code": "782365638",
"country_code": "US",
"telephone_number": "210-916-8166",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "OWEN",
"first_name": "SAMUEL",
"middle_name": "CRAIG",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2012-05-14",
"last_updated": "2025-03-07",
"certification_date": "2025-03-07",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "VA",
"license": "0101255392",
"primary": false
},
{
"code": "207RG0100X",
"taxonomy_group": "",
"desc": "Internal Medicine, Gastroenterology",
"state": "VA",
"license": "0101255392",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in San Antonio, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.