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General NPI Number Information
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NPI Number | 1376588194
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Entity Type | Individual
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Provider Name | REGAN W POLONE P.A.
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Gender | Male
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Dates
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Enumeration Date | 06/17/2006
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Last Update Date | 06/07/2018
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Provider Practice Location Address
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Address Line | 1665 ANTILLEY RD SUITE 200
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City | ABILENE
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State | TX
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Zip | 79606-5265
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Country | US
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Telephone | 325-793-5130
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Fax | 325-793-5133
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Provider Business Mailing Address
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Address Line | PO BOX 5409
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City | ABILENE
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State | TX
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Zip | 79608-5409
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Country | US
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Telephone | 325-793-5130
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Fax | 325-793-5133
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA01516
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License Number State | TX
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