Healthcare Provider Details

I. General information

NPI: 1588757462
Provider Name (Legal Business Name): LEE S POLLACK MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/02/2006
Last Update Date: 12/14/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25510 I 45 NORTH STE200
SPRING TX
77386
US

IV. Provider business mailing address

PO BOX 1059
SPRING TX
77383-1059
US

V. Phone/Fax

Practice location:
  • Phone: 281-367-1388
  • Fax: 281-681-3885
Mailing address:
  • Phone: 281-367-1388
  • Fax: 281-681-3885

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License NumberH573
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: