Individual
JUSTIN W POWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
147 COUNTY ROAD 129, HALLETTSVILLE, TX 77964-5186
(361) 798-2112
(361) 798-2112
Mailing address
PO BOX 801, HALLETTSVILLE, TX 77964-0801
(361) 798-2112
(361) 798-2112
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
J8722
TX
207Q00000X
Family Medicine Physician
TXBJ8722
TX
207R00000X
Internal Medicine Physician
TXBJ8722
TX
208000000X
Pediatrics Physician
Primary
TXBJ8722
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
111956205
—
TX
Enumeration date
08/05/2006
Last updated
07/14/2014
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