Healthcare Provider Details

I. General information

NPI: 1033399985
Provider Name (Legal Business Name): JANICE R. POWELLS, M.D., P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/08/2007
Last Update Date: 06/29/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8300 BISSONNET ST SUITE 300
HOUSTON TX
77074-3900
US

IV. Provider business mailing address

8300 BISSONNET ST SUITE 300
HOUSTON TX
77074-3900
US

V. Phone/Fax

Practice location:
  • Phone: 713-774-3443
  • Fax: 713-774-5812
Mailing address:
  • Phone: 713-774-3443
  • Fax: 713-774-5812

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberE9337
License Number StateTX

VIII. Authorized Official

Name: MR. WILLIE D POWELLS JR.
Title or Position: BUSINESS MANAGER
Credential:
Phone: 713-774-5886