Provider Demographics
NPI:1932450723
Name:POWERS, ASHLEY R (PA)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:R
Last Name:POWERS
Suffix:
Gender:F
Credentials:PA
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Mailing Address - Street 1:1400 N IH 35
Mailing Address - Street 2:SUITE 300
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78701-1926
Mailing Address - Country:US
Mailing Address - Phone:512-324-8300
Mailing Address - Fax:512-324-8301
Practice Address - Street 1:1600 W 38TH ST
Practice Address - Street 2:SUITE 200
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78731-6400
Practice Address - Country:US
Practice Address - Phone:512-324-3580
Practice Address - Fax:512-324-3581
Is Sole Proprietor?:No
Enumeration Date:2012-09-20
Last Update Date:2013-04-22
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Provider Licenses
StateLicense IDTaxonomies
TXPA07958363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX309908701Medicaid
TX309908702Medicaid
TX309908701Medicaid
TXTXB165145Medicare PIN