MEDICARE: KAELA POWERY

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	235Z00000X	Speech-Language Pathologist	120464	TX

General Provider Information

NPI Number	:	1104608173
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KAELA POWERY

Provider Business Mailing Address
First Line	:	8213 MID CITIES BLVD STE 200
Second Line	:
City	:	NORTH RICHLAND HILLS
State	:	TX
Zip	:	76182-4754
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	8213 MID CITIES BLVD STE 200
Second Line	:
City	:	NORTH RICHLAND HILLS
State	:	TX
Zip	:	76182-4754
Country	:	US
Telephone Number	:	972-454-9309
Fax Number	:	972-338-9378

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

Provider Enumeration Date	:	10/16/2023
Last Update Date	:	10/16/2023

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Directions to “ KAELA POWERY ” Practice Location

Language	Start Address	Practice Location

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