Provider Demographics
NPI:1417996356
Name:POWNER, DAVID J (MD)
Entity Type:Individual
Prefix:PROF
First Name:DAVID
Middle Name:J
Last Name:POWNER
Suffix:
Gender:M
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:PO BOX 201088
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77216-1088
Mailing Address - Country:US
Mailing Address - Phone:713-500-3500
Mailing Address - Fax:
Practice Address - Street 1:6410 FANNIN ST
Practice Address - Street 2:1020
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-3000
Practice Address - Country:US
Practice Address - Phone:832-325-7090
Practice Address - Fax:713-512-2238
Is Sole Proprietor?:No
Enumeration Date:2006-06-06
Last Update Date:2009-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL6584207RC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX049266202Medicaid
TX049266203Medicaid
TX8AR789OtherBCBSTX
TX8B8792OtherBCBS
TX8A0184Medicare PIN
TX049266202Medicaid
TX8AR789OtherBCBSTX
TXD95791Medicare UPIN