Provider Demographics
NPI:1033399985
Name:JANICE R. POWELLS, M.D., P.A.
Entity Type:Organization
Organization Name:JANICE R. POWELLS, M.D., P.A.
Other - Org Name:THE CHILDREN'S DOCTORS OF TEXAS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIE
Authorized Official - Middle Name:D
Authorized Official - Last Name:POWELLS
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:713-774-5886
Mailing Address - Street 1:8300 BISSONNET ST
Mailing Address - Street 2:SUITE 300
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77074-3900
Mailing Address - Country:US
Mailing Address - Phone:713-774-3443
Mailing Address - Fax:713-774-5812
Practice Address - Street 1:8300 BISSONNET ST
Practice Address - Street 2:SUITE 300
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77074-3900
Practice Address - Country:US
Practice Address - Phone:713-774-3443
Practice Address - Fax:713-774-5812
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-08
Last Update Date:2012-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXE9337208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX148998101Medicaid
TX148998102Medicaid