Active NPI
Tera George Polson, DO
- Pediatrics Physician
- Katy, TX
National Provider Identifier
1710508593
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- U3982
- Practice address
- 23920 Katy Fwy
Katy, TX 77494-1341 - Phone
- (281) 392-8920
- NPI assigned
- May 2, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | U3982 | TX | Primary |
Addresses
Primary practice location
23920 Katy Fwy
Katy, TX 77494-1341
Mailing address
23920 Katy Fwy Ste 310
Katy, TX 77494-0881
Phone (281) 392-8920
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20200522000760 | TX | Order and Referring Only - Pediatric Medicine | 7517388853 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| U3982 | TX | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Francisco E. Moreno M.D., P.a. | Pediatrics | Past | Accepting new patients |
Interoperability endpoints
- tpolson66555@memorialhermann.direct-ci.com
Organizations & group practices 1
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.
-
- Pediatrics Physician
- Katy, TX
- NPI 1649439365
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1588377600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1687046400000",
"number": "1710508593",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "23920 KATY FWY STE 310",
"city": "KATY",
"state": "TX",
"postal_code": "774940881",
"telephone_number": "281-392-8920"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "23920 KATY FWY",
"city": "KATY",
"state": "TX",
"postal_code": "774941341",
"telephone_number": "281-392-8920"
}
],
"practiceLocations": [],
"basic": {
"last_name": "POLSON",
"first_name": "TERA",
"middle_name": "GEORGE",
"name_prefix": "Dr.",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-05-02",
"last_updated": "2023-06-18",
"certification_date": "2023-06-18",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "TX",
"license": "U3982",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Katy, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.