# TKT ENLIGHTENMENT, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1407128218
- **Authorized official:** DR. HENRY LYSELL POLK M.D. (CEO)
- **Authorized official phone:** (210) 857-8301

## Contact information

- **Practice address:** 17720 CORPORATE WOODS DR, SAN ANTONIO, TX 78259-3500
- **Practice address phone:** (210) 495-3627
- **Practice address fax:** (210) 491-3581
- **Mailing address:** 17503 LA CANTERA PKWY, SUITE 104, \#485, SAN ANTONIO, TX 78257-8207
- **Mailing address phone:** (210) 857-8301

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2084P0804X | Child & Adolescent Psychiatry Physician | M7529 | TX | Yes |

## Other

- **Enumeration date:** 02/09/2012
- **Last updated:** 05/25/2012