Provider Demographics
NPI:1992826630
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:806-656-1801
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:806-656-1801
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:817-479-7801
Practice Address - Fax:817-840-7751
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-02
Last Update Date:2019-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX156713301Medicaid
TX156713302Medicaid
TX4679500001Medicare NSC