Provider Demographics
NPI:1891714929
Name:POWERS, JASON ZW (MD)
Entity Type:Individual
Prefix:
First Name:JASON
Middle Name:ZW
Last Name:POWERS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:7777 SOUTHWEST FWY
Mailing Address - Street 2:SUITE 900
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77074-1802
Mailing Address - Country:US
Mailing Address - Phone:713-981-9971
Mailing Address - Fax:713-981-1457
Practice Address - Street 1:902 W ALABAMA ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77006-4604
Practice Address - Country:US
Practice Address - Phone:713-933-0665
Practice Address - Fax:713-933-0664
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-19
Last Update Date:2012-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK7488207Q00000X, 207QA0401X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QA0401XAllopathic & Osteopathic PhysiciansFamily MedicineAddiction Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXH34450Medicare UPIN
00X308Medicare PIN