Provider Demographics
NPI:1225049224
Name:POLE, REKHA (MD)
Entity Type:Individual
Prefix:DR
First Name:REKHA
Middle Name:
Last Name:POLE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1820 PRESTON PARK BLVD STE 2500
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75093-3674
Mailing Address - Country:US
Mailing Address - Phone:972-733-7242
Mailing Address - Fax:972-403-1465
Practice Address - Street 1:5300 W PLANO PKWY STE 100
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-4851
Practice Address - Country:US
Practice Address - Phone:972-733-7242
Practice Address - Fax:972-403-1465
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-11
Last Update Date:2020-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG54902084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXC20563Medicare UPIN
TX00DW81Medicare ID - Type Unspecified