Healthcare Provider Details

I. General information

NPI: 1881631257
Provider Name (Legal Business Name): ADRIAN MICHAEL POLIT M.D. FFARCS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/02/2006
Last Update Date: 09/09/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

119A S SMITH ST
PLEASANTON TX
78064-4111
US

IV. Provider business mailing address

119A S SMITH ST
PLEASANTON TX
78064-4111
US

V. Phone/Fax

Practice location:
  • Phone: 830-569-3397
  • Fax: 830-569-8686
Mailing address:
  • Phone: 830-569-3397
  • Fax: 830-569-8686

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License NumberF9966
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: