Provider Demographics
NPI:1396961769
Name:POWELL, ERIN H (RPHT)
Entity type:Individual
Prefix:
First Name:ERIN
Middle Name:H
Last Name:POWELL
Suffix:
Gender:F
Credentials:RPHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:216 N EDGEFIELD RD
Mailing Address - Street 2:
Mailing Address - City:WAXAHACHIE
Mailing Address - State:TX
Mailing Address - Zip Code:75165-4154
Mailing Address - Country:US
Mailing Address - Phone:682-561-8559
Mailing Address - Fax:214-463-5121
Practice Address - Street 1:3409 WORTH ST
Practice Address - Street 2:STE 725
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75246-2029
Practice Address - Country:US
Practice Address - Phone:214-276-5621
Practice Address - Fax:214-887-0496
Is Sole Proprietor?:No
Enumeration Date:2007-04-17
Last Update Date:2013-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX123307183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician
Provider Identifiers
StateIdentifier IDID TypeIssuer
221506013946032OtherNATIONAL C.PH.T. CERTIFICATION
TX123307OtherR.PH.T. LICENSE