Provider Demographics
NPI:1912923731
Name:POLLAK, RICHARD A (DPM)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:A
Last Name:POLLAK
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:8042 WURZBACH RD
Mailing Address - Street 2:450
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78229-3818
Mailing Address - Country:US
Mailing Address - Phone:210-899-1026
Mailing Address - Fax:210-692-0805
Practice Address - Street 1:8042 WURZBACH RD
Practice Address - Street 2:450
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-3818
Practice Address - Country:US
Practice Address - Phone:210-899-1026
Practice Address - Fax:210-692-0805
Is Sole Proprietor?:No
Enumeration Date:2006-07-14
Last Update Date:2019-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX0671213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX110590001Medicaid
TXT15330Medicare UPIN
TX882607Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER