MEDICARE: DEBBY LOUISE POLOZECK FNP-C

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	363LF0000X	Family Nurse Practitioner	AP128855	TX
2	163W00000X	Registered Nurse	693242	TX

General Provider Information

NPI Number	:	1275786576
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DEBBY LOUISE POLOZECK FNP-C

Provider Business Mailing Address
First Line	:	1017 12TH AVE
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76104-3915
Country	:	US
Telephone Number	:	817-334-2800
Fax Number	:	817-820-0094

Provider Business Practice Location Address
First Line	:	12590 FM 2331
Second Line	:
City	:	GODLEY
State	:	TX
Zip	:	76044-3319
Country	:	US
Telephone Number	:	817-250-7285
Fax Number	:

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

Provider Enumeration Date	:	10/30/2008
Last Update Date	:	02/21/2026

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