Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251P0200X | Physical Therapist - Pediatrics | 1022853 | TX |
NPI | 1013157486 |
---|---|
Provider Name | Elaine Powers |
First Address | Austin, TX 78727-7174 |
Second Address | Austin, TX 78727-7174 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/02/2009 |
Last Update Date | 17/03/2018 |