MEDICARE: ADNANN S POLANI 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
1	207R00000X	Internal Medicine Physician	56321	WI
2	207RN0300X	Nephrology Physician	P4230	TX

General Provider Information

NPI Number	:	1700198405
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ADNANN S POLANI MD

Provider Business Mailing Address
First Line	:	10611 GARLAND RD STE 105
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75218-2680
Country	:	US
Telephone Number	:	319-621-3572
Fax Number	:

Provider Business Practice Location Address
First Line	:	10611 GARLAND RD STE 105
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75218-2680
Country	:	US
Telephone Number	:	469-904-2020
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/10/2010
Last Update Date	:	07/11/2023

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