MEDICARE: ADRIANE POWELL

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	183500000X	Pharmacist	37672	TX

General Provider Information

NPI Number	:	1558847152
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ADRIANE POWELL

Provider Business Mailing Address
First Line	:	8080 TRISTAR DR STE 120
Second Line	:
City	:	IRVING
State	:	TX
Zip	:	75063-2823
Country	:	US
Telephone Number	:	972-815-0460
Fax Number	:

Provider Business Practice Location Address
First Line	:	8080 TRISTAR DR STE 120
Second Line	:
City	:	IRVING
State	:	TX
Zip	:	75063-2823
Country	:	US
Telephone Number	:	972-815-0460
Fax Number	:

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

Provider Enumeration Date	:	07/17/2018
Last Update Date	:	07/17/2018

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Directions to “ ADRIANE POWELL ” Practice Location

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