MEDICARE: DR. JANICE RUTH POWELLS M. D., P. A.

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	208000000X	Pediatrics Physician	E9337	TX
2	2080A0000X	Pediatric Adolescent Medicine Physician	E9337	TX

General Provider Information

NPI Number	:	1104850650
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JANICE RUTH POWELLS M. D., P. A.

Provider Business Mailing Address
First Line	:	8300 BISSONNET ST
Second Line	:	SUITE 300
City	:	HOUSTON
State	:	TX
Zip	:	77074-3900
Country	:	US
Telephone Number	:	713-774-3443
Fax Number	:	713-774-5812

Provider Business Practice Location Address
First Line	:	8300 BISSONNET ST
Second Line	:	SUITE 300
City	:	HOUSTON
State	:	TX
Zip	:	77074-3900
Country	:	US
Telephone Number	:	713-774-3443
Fax Number	:	713-774-5812

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

Provider Enumeration Date	:	07/10/2006
Last Update Date	:	11/08/2007

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