Provider Demographics
NPI:1417915802
Name:POLLARD RUIZ, JENNIFER BLAIR (MD)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:BLAIR
Last Name:POLLARD RUIZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:BLAIR
Other - Last Name:POLLARD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6300 BEE CAVES RD STE 450
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78746-5832
Mailing Address - Country:US
Mailing Address - Phone:512-829-0565
Mailing Address - Fax:512-309-7031
Practice Address - Street 1:6300 BEE CAVES RD STE 450
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78746-5832
Practice Address - Country:US
Practice Address - Phone:512-829-0565
Practice Address - Fax:512-309-7031
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-03
Last Update Date:2023-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXP5450207Q00000X, 207QA0505X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult MedicineGroup - Single Specialty