Provider Demographics
NPI:1629365796
Name:POWELL, JUNIOUS KEITH (PHARMD)
Entity type:Individual
Prefix:DR
First Name:JUNIOUS
Middle Name:KEITH
Last Name:POWELL
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31303 FM 2920 RD STE H
Mailing Address - Street 2:
Mailing Address - City:WALLER
Mailing Address - State:TX
Mailing Address - Zip Code:77484-8196
Mailing Address - Country:US
Mailing Address - Phone:713-725-2211
Mailing Address - Fax:
Practice Address - Street 1:31303 FM 2920 RD STE H
Practice Address - Street 2:
Practice Address - City:WALLER
Practice Address - State:TX
Practice Address - Zip Code:77484-8196
Practice Address - Country:US
Practice Address - Phone:713-725-2211
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-08
Last Update Date:2024-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX52873183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist