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NPI Code Detail

MEDICARE: DR. DANIEL POLANCO MD

MEDICARE:  DR. DANIEL  POLANCO  MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207R00000XInternal Medicine PhysicianL2557TX

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
48707B9OTHERTXMEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3TXB154608OTHERTXWELLMED PTAN

General Provider Information

NPI Number : 1568469856
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. DANIEL POLANCO MD
Provider Business Mailing Address
First Line : 7430 REMCON CIR
Second Line : BLDG A
City : EL PASO
State : TX
Zip : 79912-3514
Country : US
Telephone Number : 915-584-0051
Fax Number : 915-833-1114
Provider Business Practice Location Address
First Line : 7430 REMCON CIR
Second Line : BLDG A
City : EL PASO
State : TX
Zip : 79912-3514
Country : US
Telephone Number : 915-584-0051
Fax Number : 915-833-1114
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/01/2005
Last Update Date : 10/15/2015

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Directions to “ DR. DANIEL POLANCO MD” Practice Location

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