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NPI Code Detail

MEDICARE: ANNE POWELL

MEDICARE:   ANNE  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
11223G0001XGeneral Practice Dentistry22938TX

General Provider Information

NPI Number : 1902967425
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANNE POWELL
Provider Business Mailing Address
First Line : 650 INTERNATIONAL PKWY
Second Line : SUITE 100
City : RICHARDSON
State : TX
Zip : 75081-6612
Country : US
Telephone Number : 817-238-7984
Fax Number :
Provider Business Practice Location Address
First Line : 6628 LAKE WORTH BLVD
Second Line : SUITE 200
City : LAKE WORTH
State : TX
Zip : 76135-3018
Country : US
Telephone Number : 817-238-7984
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/12/2006
Last Update Date : 07/08/2007

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Directions to “ ANNE POWELL ” Practice Location

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