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General NPI Number Information
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NPI Number | 1194882241
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Entity Type | Individual
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Provider Name | CHERYL ANN POLKOWSKI M.D.
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Gender | Female
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Dates
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Enumeration Date | 01/01/2007
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Last Update Date | 10/28/2019
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Provider Practice Location Address
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Address Line | 300 WILSON ST
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City | HENDERSON
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State | TX
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Zip | 75652-5956
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Country | US
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Telephone | 903-655-6536
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Fax | 903-655-4009
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Provider Business Mailing Address
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Address Line | PO BOX 938
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City | KILLEEN
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State | TX
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Zip | 76540-0938
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Country | US
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Telephone | 254-634-6999
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Fax | 254-200-4099
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | M8257
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License Number State | TX
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