Individual provider Active NPI

Peter Allen Powaser, M.D.

  • Anatomic Pathology & Clinical Pathology Physician
  • Conroe, TX
National Provider Identifier
1114922168
Registry record updated Mar 19, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
L5207 Issued in TX
Practice address
504 Medical Center Blvd
Conroe, TX 77304-2808
Phone
(713) 481-3544
Fax
(713) 432-0221
NPI assigned
Jun 16, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2009

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X L5207 TX Primary

Addresses

Primary practice location

504 Medical Center Blvd
Conroe, TX 77304-2808

Mailing address

PO Box 4677
Houston, TX 77210-4677

Other identifiers 1

IdentifierTypeStateIssuer
P00006404OtherTXRAILROAD MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090403000150 TX Practitioner - Pathology 3375690654 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
Baylor College of Medicine, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Baylor College of MedicineGroup PAC ID 8527956176, 47 clinicians

Practice addresses (Care Compare)

4600 E Sam Houston Pkwy S
Community Pathology
Pasadena, TX 77505-3948
Phone (713) 948-7000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
L5207TXMDAnatomic Pathology & Clinical Pathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Baylor College of Medicine Anatomic Pathology & Clinical Pathology CurrentSince Nov 21, 2002 Accepting new patients
Baylor College of Medicine Anatomic Pathology & Clinical Pathology Past Accepting new patients
Citizens Medical Center County of Victoria Past Accepting new patients

Locations

1115 Avenue G
Bay City, TX 77414
Phone (979) 245-6383

504 Medical Center Blvd
Conroe, TX 77304
Phone (936) 539-1111

3200 Wilcrest Dr
Ste 600
Houston, TX 77042

481 Ih 45 S
Ste 7
Huntsville, TX 77340
Phone (409) 291-9704

700 E Marshall Ave
Longview, TX 75601
Phone (903) 236-2000

304 University Ave
Marshall, TX 75670
Phone (903) 935-7821

311 Green Ave
Palacios, TX 77465
Phone (361) 972-2511

4600 E Sam Houston Pkwy S
Pasadena, TX 77505
Phone (713) 853-9302

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1118880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1237420800000",
    "number": "1114922168",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4677",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "772104677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "504 MEDICAL CENTER BLVD",
            "city": "CONROE",
            "state": "TX",
            "postal_code": "773042808",
            "telephone_number": "713-481-3544",
            "fax_number": "713-432-0221"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POWASER",
        "first_name": "PETER",
        "middle_name": "ALLEN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-16",
        "last_updated": "2009-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "TX",
            "license": "L5207",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00006404",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Conroe, TX

Sources for this page

Verify at the official NPI Registry.