Provider Demographics
NPI:1548583222
Name:ALICIA A POLLARD
Entity Type:Organization
Organization Name:ALICIA A POLLARD
Other - Org Name:RIVERTREE RESOURCE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ALICIA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:POLLARD
Authorized Official - Suffix:
Authorized Official - Credentials:RRT/RCP
Authorized Official - Phone:816-656-1801
Mailing Address - Street 1:PO BOX 820103
Mailing Address - Street 2:
Mailing Address - City:NORTH RICHLAND HILLS
Mailing Address - State:TX
Mailing Address - Zip Code:76182-0103
Mailing Address - Country:US
Mailing Address - Phone:817-479-3330
Mailing Address - Fax:817-840-7751
Practice Address - Street 1:7801 BRANDI LN STE H
Practice Address - Street 2:
Practice Address - City:NORTH RICHLAND HILLS
Practice Address - State:TX
Practice Address - Zip Code:76182-4697
Practice Address - Country:US
Practice Address - Phone:817-479-3330
Practice Address - Fax:817-840-7751
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:RIVERTREE RESOURCE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-03-09
Last Update Date:2019-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX156713302Medicaid
TX156713301Medicaid
TX4679500002Medicare PIN
TX156713302Medicaid