Provider Demographics
NPI:1780869875
Name:POWERS FAMILY WELLNESS PLLC
Entity type:Organization
Organization Name:POWERS FAMILY WELLNESS PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:V
Authorized Official - Last Name:POWERS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:512-794-9500
Mailing Address - Street 1:8127 MESA DR STE C301
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78759-8632
Mailing Address - Country:US
Mailing Address - Phone:512-794-9500
Mailing Address - Fax:512-794-9559
Practice Address - Street 1:8127 MESA DR STE C301
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78759-8632
Practice Address - Country:US
Practice Address - Phone:512-794-9500
Practice Address - Fax:512-794-9559
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-08
Last Update Date:2009-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX8320111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX609291OtherMEDICARE PTAN