Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | BP10035458 | TX |
Y | 208000000X | Pediatrician | P4231 | TX |
NPI | 1003043134 |
---|---|
Provider Name | Dr. Lorraine E. Powell |
First Address | Austin, TX 78703-1324 |
Second Address | Austin, TX 78703-1324 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/06/2009 |
Last Update Date | 09/06/2021 |