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General NPI Number Information
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NPI Number | 1194777276
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Entity Type | Individual
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Provider Name | LAURA POWELL P.A.C.
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Gender | Female
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Dates
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Enumeration Date | 05/16/2006
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Last Update Date | 04/30/2025
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Provider Practice Location Address
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Address Line | 5525 TRAVIS CT
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City | TEMPLE
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State | TX
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Zip | 76502-6657
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Country | US
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Telephone | 409-594-5450
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Fax |
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Provider Business Mailing Address
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Address Line | 5525 TRAVIS CT
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City | TEMPLE
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State | TX
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Zip | 76502-6657
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Country | US
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Telephone | 409-594-5450
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA01415
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | PA01415
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License Number State | TX
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