Healthcare Provider Details

I. General information

NPI: 1902578776
Provider Name (Legal Business Name): POLLACK NEURODIAGNOSTICS & NEUROMEDICAL MANAGEMENT P.A
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/30/2021
Last Update Date: 09/30/2021
Certification Date: 09/30/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25010 OAKHURST DR STE 200
SPRING TX
77386-1916
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 Number
License Number State

VIII. Authorized Official

Name: LEE STUART POLLACK
Title or Position: PRESIDENT
Credential: MD
Phone: 281-367-1388