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Individual

DR. JERRY ALLEN POWELL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
5323 HARRY HINES BLVD., DALLAS, TX 75390
(214) 456-5776
Mailing address
PO BOX 845347, DALLAS, TX 75284-5347

Taxonomy

Speciality
Code
Description
License number
State
2085P0229X
Pediatric Radiology Physician
Primary
L3438
TX
2085R0202X
Diagnostic Radiology Physician
L3438
TX

Other

Enumeration date
07/22/2005
Last updated
01/09/2023
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