Provider Demographics
NPI:1619266533
Name:POLLARD, ELIZABETH CYRENNA (MD)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:CYRENNA
Last Name:POLLARD
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:PO BOX 911230
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75391-8077
Mailing Address - Country:US
Mailing Address - Phone:972-234-0813
Mailing Address - Fax:972-234-0813
Practice Address - Street 1:515 W MAYFIELD RD STE 101
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76014-2084
Practice Address - Country:US
Practice Address - Phone:817-664-4400
Practice Address - Fax:817-664-4435
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-31
Last Update Date:2018-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXQ0995207R00000X, 207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXP01932485OtherRAILROAD
TX370832301Medicaid