Active NPI
Sean Ryan Pollock, CCP, LP
- Perfusionist
- Dallas, TX
National Provider Identifier
1811610710
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Perfusionist
- License
- MB-718835
- Practice address
- 8200 Walnut Hill LN
Dallas, TX 75231-4402 - Phone
- (214) 345-6789
- NPI assigned
- Sep 26, 2022
- Last updated
- Sep 26, 2022
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Perfusionist | 242T00000X | MB-718835 | TX | Primary |
Addresses
Primary practice location
8200 Walnut Hill LN
Dallas, TX 75231-4402
Mailing address
206 Windmill Ridge Dr
Rockwall, TX 75032-5605
Phone (214) 728-5756
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MB-718835 | TX | MD | Perfusionist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1664150400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1664150400000",
"number": "1811610710",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "206 WINDMILL RIDGE DR",
"city": "ROCKWALL",
"state": "TX",
"postal_code": "750325605",
"telephone_number": "214-728-5756"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8200 WALNUT HILL LN",
"city": "DALLAS",
"state": "TX",
"postal_code": "752314402",
"telephone_number": "214-345-6789"
}
],
"practiceLocations": [],
"basic": {
"last_name": "POLLOCK",
"first_name": "SEAN",
"middle_name": "RYAN",
"credential": "CCP, LP",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-09-26",
"last_updated": "2022-09-26",
"certification_date": "2022-09-25",
"status": "A"
},
"taxonomies": [
{
"code": "242T00000X",
"taxonomy_group": "",
"desc": "Perfusionist",
"state": "TX",
"license": "MB-718835",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Dallas, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 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.