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General NPI Number Information
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NPI Number | 1891264149
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Entity Type | Individual
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Provider Name | KRISTEN MARY POLASKI PT, DPT
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Gender | Female
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Dates
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Enumeration Date | 11/15/2018
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Last Update Date | 11/15/2018
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Provider Practice Location Address
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Address Line | 940 CLEAR LAKE CITY BLVD
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City | WEBSTER
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State | TX
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Zip | 77598-6606
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Country | US
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Telephone | 281-282-1900
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Fax | 281-282-1990
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Provider Business Mailing Address
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Address Line | 1 HERMANN MUSEUM CIRCLE DR APT 4020
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City | HOUSTON
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State | TX
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Zip | 77004-7385
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Country | US
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Telephone | 610-306-9687
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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 | 2251P0200X
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Taxonomy Name | Pediatric Physical Therapist
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License Number | 1304068
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License Number State | TX
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