MEDICARE: ELIZABETH LOUISE POHLMANN DDS

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	122300000X	Dentist	39677	TX

General Provider Information

NPI Number	:	1609551712
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ELIZABETH LOUISE POHLMANN DDS

Provider Business Mailing Address
First Line	:	18111 LA CANTERA TER APT 4407
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78256-2688
Country	:	US
Telephone Number	:	830-964-3161
Fax Number	:

Provider Business Practice Location Address
First Line	:	1395 SATTLER RD STE 4
Second Line	:
City	:	CANYON LAKE
State	:	TX
Zip	:	78132-2296
Country	:	US
Telephone Number	:	830-964-3161
Fax Number	:

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

Provider Enumeration Date	:	06/16/2023
Last Update Date	:	03/08/2026

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