Lilliam Polo

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

12045 Issued in TX

Practice address

1626 W Hwy 287 Bus Ste 101
Waxahachie, TX 75165-4728

Phone

(214) 864-6988

Fax

(972) 906-9112

NPI assigned

Feb 3, 2016

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• The Polo Group LLC

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Waxahachie, TX
  • NPI 1083233498
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1454457600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1586908800000",
    "number": "1134587314",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1626 W HWY 287 BUS STE 101",
            "city": "WAXAHACHIE",
            "state": "TX",
            "postal_code": "751654728",
            "telephone_number": "214-864-6988",
            "fax_number": "972-906-9112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1626 W HWY 287 BUS STE 101",
            "city": "WAXAHACHIE",
            "state": "TX",
            "postal_code": "751654728",
            "telephone_number": "214-864-6988",
            "fax_number": "972-906-9112"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3300 Oak Lawn Ave Ste 107",
            "address_purpose": "LOCATION",
            "city": "Dallas",
            "state": "TX",
            "postal_code": "752194438",
            "country_code": "US",
            "telephone_number": "972-906-9112",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "POLO",
        "first_name": "LILLIAM",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-02-03",
        "last_updated": "2020-04-15",
        "certification_date": "2020-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "TX",
            "license": "12045",
            "primary": false
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "TX",
            "license": "12045",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "TX",
            "license": "12045",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1013287721",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Podiatric Medical Partners of Texas, PA
• Point Rehab LLC
• William Stephen Polachek, MD
• Farhana Karim Polara, M.D.
• April Polite
• Tanner Pool
• April Suzanne Powell, PHARM D
• Patti Gilbert Powell, M.D.
• Mladen Predanic, MD MSC
• Preferred Cardio Checkup Management LLC

• Addiction (Substance Use Disorder) Counselor in Waxahachie, TX
• Providers in Waxahachie, TX by specialty
• Addiction (Substance Use Disorder) Counselor in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.