David Ronald Polasek, RPH
Individual provider Active NPI Pharmacist · Cuero, TX
NPI 1710202098 · NPPES record last updated Mar 30, 2010
Key facts
- NPI
- 1710202098
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 19953 (TX)
- Practice address
- 515 N Esplanade
Cuero, TX 77954-0270 - Phone
- (361) 275-3332
- Fax
- (361) 275-3829
- NPI assigned
- Mar 30, 2010
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Registered Pharmacist
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 19953 | TX | Yes |
Addresses
Primary practice location
515 N Esplanade
Cuero, TX 77954-0270
Mailing address
114 Main St
Cuero, TX 77954-0270
Phone (361) 275-3332
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 143644 | Medicaid | TX |
Other providers in Cuero, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 30, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.