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General NPI Number Information
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NPI Number | 1760874242
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Entity Type | Individual
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Provider Name | MRS. NATALIA RAE POLLOK
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Gender | Female
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Dates
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Enumeration Date | 02/20/2015
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Last Update Date | 02/26/2015
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Provider Practice Location Address
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Address Line | 749 WILLMANN RD
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City | SEGUIN
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State | TX
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Zip | 78155-0491
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Country | US
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Telephone | 830-303-4497
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Fax |
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Provider Business Mailing Address
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Address Line | HWY 90 CROSS STREET SW MILITARY DR.
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City | LACKLAND AIR FORCE BASE
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State | TX
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Zip | 78263-5113
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Country | US
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Telephone | 210-671-6397
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Fax |
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 30846
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License Number State | TX
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