Provider Demographics
NPI:1417501818
Name:POLLARD, CARL
Entity Type:Individual
Prefix:
First Name:CARL
Middle Name:
Last Name:POLLARD
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6496 IRON HORSE BLVD APT 1101
Mailing Address - Street 2:
Mailing Address - City:NORTH RICHLAND HILLS
Mailing Address - State:TX
Mailing Address - Zip Code:76180-6143
Mailing Address - Country:US
Mailing Address - Phone:682-373-3075
Mailing Address - Fax:
Practice Address - Street 1:6496 IRON HORSE BLVD APT 1101
Practice Address - Street 2:
Practice Address - City:NORTH RICHLAND HILLS
Practice Address - State:TX
Practice Address - Zip Code:76180-6143
Practice Address - Country:US
Practice Address - Phone:682-373-3075
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-25
Last Update Date:2023-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV1700246949Medicaid