Provider Demographics
NPI:1104850650
Name:POWELLS, JANICE RUTH (M D, P A)
Entity Type:Individual
Prefix:DR
First Name:JANICE
Middle Name:RUTH
Last Name:POWELLS
Suffix:
Gender:F
Credentials:M D, P A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
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
Is Sole Proprietor?:No
Enumeration Date:2006-07-10
Last Update Date:2007-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXE9337208000000X, 2080A0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXC20657Medicare UPIN