| Michael J Polski Md Pa | |
|
1310 Nw John Jones Dr Burleson TX 76028-8040 | |
| (817) 297-1297 | |
| (817) 297-6363 |
| Full Name | Michael J Polski Md Pa |
|---|---|
| Speciality | Family Medicine |
| Location | 1310 Nw John Jones Dr, Burleson, Texas |
| Authorized Official Name and Position | Michael J Polski (CEO/OWNER) |
| Authorized Official Contact | 8172971297 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Michael J Polski Md Pa 1310 Nw John Jones Dr Burleson TX 76028-8040 Ph: (817) 297-1297 | Michael J Polski Md Pa 1310 Nw John Jones Dr Burleson TX 76028-8040 Ph: (817) 297-1297 |
| NPI Number | 1417233586 |
|---|---|
| Provider Enumeration Date | 11/02/2011 |
| Last Update Date | 11/02/2011 |
| Medicare PECOS PAC ID | 4486829835 |
|---|---|
| Medicare Enrollment ID | O20111213000616 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417233586 | NPI | - | NPPES |
| 139817405 | Medicaid | TX | |
| 139817420 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | H9592 (Texas) | Primary |
| Provider Name | Michael J Polski |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1952342487 PECOS PAC ID: 2961399548 Enrollment ID: I20040228000352 |
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