Provider Demographics
NPI:1235429036
Name:PATRICK H POWNELL MD P A
Entity Type:Organization
Organization Name:PATRICK H POWNELL MD P A
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:PATRICK
Authorized Official - Middle Name:
Authorized Official - Last Name:POWNELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-368-3223
Mailing Address - Street 1:7115 GREENVILLE AVE
Mailing Address - Street 2:SUITE 220
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75231-5100
Mailing Address - Country:US
Mailing Address - Phone:214-368-3223
Mailing Address - Fax:214-368-3177
Practice Address - Street 1:7115 GREENVILLE AVE
Practice Address - Street 2:SUITE 220
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75231-5100
Practice Address - Country:US
Practice Address - Phone:214-368-3223
Practice Address - Fax:214-368-3177
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-13
Last Update Date:2011-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH2695174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXD87472Medicare UPIN