Individual
DR. AVANELL POWER OATES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
531 GASLIGHT BLVD., LUFKIN, TX 75904
(936) 632-7010
(936) 632-9602
Mailing address
1623 HOMER COOPER ROAD, MARSHALL, TX 75672
(903) 938-8550
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
24805
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
171800901
—
TX
01
—
86946A
BCBS
TX
Enumeration date
07/08/2005
Last updated
09/03/2010
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