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General NPI Number Information
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NPI Number | 1831334382
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Entity Type | Individual
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Provider Name | KEITH A POWELL
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Gender | Male
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Dates
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Enumeration Date | 12/12/2008
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Last Update Date | 12/12/2008
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Provider Practice Location Address
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Address Line | 1472 N. HAMPTON ROAD SUITE 111
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City | DESOTO
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State | TX
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Zip | 75115-3033
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Country | US
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Telephone | 972-224-4015
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Fax | 972-224-4339
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Provider Business Mailing Address
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Address Line | PO BOX 425
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City | CEDAR HILL
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State | TX
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Zip | 75106-0425
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Country | US
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Telephone | 972-224-4015
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Fax | 972-224-4339
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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 | 341600000X
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Taxonomy Name | Ambulance
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License Number |
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License Number State |
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