Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Y00000X | Otolaryngologist (ENT Doctor) | P5710 | TX |
Y | 207YP0228X | Pediatric Otolaryngology | P5710 | TX |
NPI | 1386840692 |
---|---|
Provider Name | Rosser Kennedy Powitzky |
First Address | Dallas, TX 75284-4658 |
Second Address | Temple, TX 76508-0001 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/06/2007 |
Last Update Date | 05/01/2021 |