Provider Demographics
NPI:1013319482
Name:POLK, JANEY (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:JANEY
Middle Name:
Last Name:POLK
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:66 GRUENE PARK DR
Mailing Address - Street 2:SUITE 109
Mailing Address - City:NEW BRAUNFELS
Mailing Address - State:TX
Mailing Address - Zip Code:78130-2218
Mailing Address - Country:US
Mailing Address - Phone:830-214-6411
Mailing Address - Fax:
Practice Address - Street 1:66 GRUENE PARK DR
Practice Address - Street 2:SUITE 109
Practice Address - City:NEW BRAUNFELS
Practice Address - State:TX
Practice Address - Zip Code:78130-2218
Practice Address - Country:US
Practice Address - Phone:830-214-6411
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-09-17
Last Update Date:2014-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant