Individual
DR. DEANNA J POWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
1228 US 377, ROANOKE, TX 76262-7280
(904) 584-2230
(913) 254-9613
Mailing address
12934 GRANDSTAND WAY, FORT WORTH, TX 76244-7280
(904) 584-2230
(913) 254-9613
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
8320T
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
20-3384798
UHC
KS
01
—
203384798
FREEDOM NETWORK
KS
01
—
20338479866220A002
TRICARE
KS
01
—
31795041
BC/BS OF KC
KS
01
—
7038483
AETNA
KS
Enumeration date
04/11/2006
Last updated
10/01/2021
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