MEDICARE: DR. JAMES DAVID POLK DO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207P00000X	Emergency Medicine Physician	L2558	TX
2	2083A0100X	Aerospace Medicine Physician	L2558	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1194703447
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JAMES DAVID POLK DO

Provider Business Mailing Address
First Line	:	711 RED OAK LN
Second Line	:
City	:	FRIENDSWOOD
State	:	TX
Zip	:	77546-3591
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	JOHNSON SPACE CENTER- NASA FLIGHT MEDICINE CLINIC
Second Line	:	2101 NASA ROAD 1
City	:	HOUSTON
State	:	TX
Zip	:	77058
Country	:	US
Telephone Number	:	281-483-6063
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/06/2006
Last Update Date	:	09/11/2025

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