Healthcare Provider Details

I. General information

NPI: 1982753620
Provider Name (Legal Business Name): GARRY R POLLOCK, M.D., P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/10/2007
Last Update Date: 01/28/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4642 N LOOP 289 STE 105
LUBBOCK TX
79416-2422
US

IV. Provider business mailing address

4642 N LOOP 289 STE 105
LUBBOCK TX
79416-2422
US

V. Phone/Fax

Practice location:
  • Phone: 806-771-3030
  • Fax:
Mailing address:
  • Phone: 806-771-3030
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207XS0106X
TaxonomyOrthopaedic Hand Surgery Physician
License NumberJ0204
License Number StateTX

VIII. Authorized Official

Name: DR. GARRY R POLLOCK
Title or Position: OWNER
Credential: M.D.
Phone: 806-771-3030