Provider Demographics
NPI:1134154883
Name:POWELL, CHRISTIE JEAN (PT)
Entity type:Individual
Prefix:
First Name:CHRISTIE
Middle Name:JEAN
Last Name:POWELL
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13805 RESEARCH BLVD STE 140
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78750-1385
Mailing Address - Country:US
Mailing Address - Phone:512-996-0441
Mailing Address - Fax:512-996-0442
Practice Address - Street 1:13805 RESEARCH BLVD STE 150
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78750-1400
Practice Address - Country:US
Practice Address - Phone:512-996-0441
Practice Address - Fax:512-996-0442
Is Sole Proprietor?:No
Enumeration Date:2006-07-11
Last Update Date:2009-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1142511225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX9260655OtherPHCS
TX8T4365OtherBCBX
TX9260655OtherPHCS