Polk, Maria Gwendoline

Polk, Maria Gwendoline is an sole proprietor health care provider with primary practice located at 4660 Beechnut St Ste 218-A , Houston TX 77096-1824. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Gerontology, which is considered as her primary health care specialty. Polk, Maria Gwendoline can be contacted via phone (713) 521-0006.

Contact Information

Primary practice address
4660 Beechnut St Ste 218-A Houston TX 77096-1824
Phone: (713) 521-0006
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Gerontology 363LG0600X 425936 Texas

Profile Details

NPI number 1093838526
LBN Legal business name Polk, Maria Gwendoline
Credentials RN MSN GNP-BC
Entity Individual
Sole proprietor 1 Yes
Enumeration date Apr 9th, 2007
Last updated Jul 11th, 2012 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1093838526 NPPES
Texas Other P00731415 MEDICARE RAILROAD
Texas Other P00784266 MEDICARE RAILROAD
Texas MEDICAID 190358502 MEDICARE RAILROAD
Texas Other 8Y3481 MEDICARE RAILROAD

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