Provider Demographics
NPI:1174268841
Name:POWELL, KAYLA (MD)
Entity Type:Individual
Prefix:
First Name:KAYLA
Middle Name:
Last Name:POWELL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:618 BRAUGHAM RD
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46227-2504
Mailing Address - Country:US
Mailing Address - Phone:704-910-9197
Mailing Address - Fax:
Practice Address - Street 1:6550 FANNIN ST STE 1723
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-2747
Practice Address - Country:US
Practice Address - Phone:346-238-6287
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-28
Last Update Date:2022-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program