MEDICARE: ELIZABETH POWELL

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363L00000X	Nurse Practitioner	1207715	TX

General Provider Information

NPI Number	:	1730043621
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ELIZABETH POWELL

Provider Business Mailing Address
First Line	:	2710 KINGSBURY PARK LN
Second Line	:
City	:	SPRING
State	:	TX
Zip	:	77386-3084
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2710 KINGSBURY PARK LN
Second Line	:
City	:	SPRING
State	:	TX
Zip	:	77386-3084
Country	:	US
Telephone Number	:	832-289-3214
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/15/2025
Last Update Date	:	12/15/2025

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