South Polk Medical Clinic Llc is a Nurse Practitioner based in Dallas, TX. South Polk Medical Clinic Llc practices in Dallas, TX. The NPI Number for South Polk Medical Clinic Llc is 1043351760 and holds a License No. 578285 (Texas).
The current practice location address for South Polk Medical Clinic Llc is 3436 S Polk St, Dallas, TX and can be reached out via phone at 214-372-1051 and via fax at 214-372-9201.
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 155741503 | 05 | TX | |
| 190227201 | 05 | TX | |
| 0041PN | 01 | TX | BLUE CROSS BLUE SHIELD OF TEXAS |
| 7149594 | 01 | TX | AETNA |
| 155741504 | 05 | TX | |
| 4567567 | 01 | TX | CIGNA |
| 190227202 | 05 | TX | |
| 10008701 | 01 | TX | AMERIGROUP |
| 562313709 | 01 | TX | OLD TAX ID |
| NP7128 | 01 | TX | BLUE CROSS BLUE SHIELD |
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