Individual provider Active NPI

Tera George Polson, DO

  • Pediatrics Physician
  • Katy, TX
National Provider Identifier
1710508593
Registry record updated Jun 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
U3982 Issued in TX
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

Updated by the provider on Jun 18, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200522000760 TX Order and Referring Only - Pediatric MedicinePractitioner - Pediatric Medicine 7517388853

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
U3982TXMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Francisco E. Moreno M.D., P.a. Pediatrics PastSince Jun 25, 2023 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: 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.

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

Verify at the official NPI Registry.