Provider Demographics
NPI:1760874242
Name:POLLOK, NATALIA RAE
Entity Type:Individual
Prefix:MRS
First Name:NATALIA
Middle Name:RAE
Last Name:POLLOK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:HWY 90 CROSS STREET SW MILITARY DR.
Mailing Address - Street 2:
Mailing Address - City:LACKLAND AIR FORCE BASE
Mailing Address - State:TX
Mailing Address - Zip Code:78263-5113
Mailing Address - Country:US
Mailing Address - Phone:210-671-6397
Mailing Address - Fax:
Practice Address - Street 1:749 WILLMANN RD
Practice Address - Street 2:
Practice Address - City:SEGUIN
Practice Address - State:TX
Practice Address - Zip Code:78155-0491
Practice Address - Country:US
Practice Address - Phone:830-303-4497
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-02-20
Last Update Date:2015-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX30846183500000X, 1835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
Yes183500000XPharmacy Service ProvidersPharmacist