Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208000000X | Pediatrician | E9337 | TX |
N | 2080A0000X | Adolescent Medicine | E9337 | TX |
NPI | 1104850650 |
---|---|
Provider Name | Dr. Janice Ruth Powells |
First Address | Houston, TX 77074-3900 |
Second Address | Houston, TX 77074-3900 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/07/2006 |
Last Update Date | 08/11/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
C20657 | (02) | TX |