Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2100X | Nurse Practitioner - Acute Care | AP135948 | TX |
NPI | 1013421122 |
---|---|
Provider Name | Mr. David Allen Powell |
First Address | Houston, TX 77044-4548 |
Second Address | Kingwood, TX 77339-4412 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/11/2017 |
Last Update Date | 28/11/2017 |