Organization
POWELL PROFESSIONAL OF WEST TEXAS, LLC
Active
Other names
Guardian EMS
Organization subpart
No
Provider details
NPI number
Authorized official
RICKY LEE POWELL (MEMBER)
(979) 733-0010
Entity
Organization
Contact information
Practice address
1501 4TH ST, BROWNWOOD, TX 76801-4430
(325) 643-4840
Mailing address
1239 BOWIE ST, COLUMBUS, TX 78934-2343
(979) 733-0010
(979) 733-0051
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
100469
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
100469
TEXAS DEPARTMENT OF STATE HEALTH SERVICES
TX
Enumeration date
06/23/2010
Last updated
07/28/2010
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