Individual provider Active NPI

Rosenthalia Renee Polk, CSA

  • Surgical Technologist
  • Sugar Land, TX
National Provider Identifier
1285988220
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical TechnologistTaxonomy code 246ZS0410X
Practice address
2743 Ferry LNDG
Sugar Land, TX 77478-4314
Phone
(713) 254-3010
Fax
(713) 234-7101
NPI assigned
Oct 30, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Technologist 246ZS0410X TX Primary

Addresses

Primary practice location

2743 Ferry LNDG
Sugar Land, TX 77478-4314

Mailing address

22307 Elsinore Dr
Katy, TX 77450-1634
Phone (832) 407-4353

Other names 1

  • Rose Polk Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1351555200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1285988220",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22307 ELSINORE DR",
            "city": "KATY",
            "state": "TX",
            "postal_code": "774501634",
            "telephone_number": "832-407-4353"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2743 FERRY LNDG",
            "city": "SUGAR LAND",
            "state": "TX",
            "postal_code": "774784314",
            "telephone_number": "713-254-3010",
            "fax_number": "713-234-7101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLK",
        "first_name": "ROSENTHALIA",
        "middle_name": "RENEE",
        "name_prefix": "Ms.",
        "credential": "CSA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-10-30",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "246ZS0410X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Other, Surgical Technologist",
            "state": "TX",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ROSE",
            "last_name": "POLK",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Sugar Land, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.