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Individual

POLLY A RETZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RN, CPNP

Contact information

Practice address
11714 WILSON PARKE AVE STE 150, AUSTIN, TX 78726-4061
(512) 346-6611
(512) 406-6267
Mailing address
6210 E HWY 290 STE 240, AUSTIN, TX 78723-1144

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
587900
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
182838605
TX
05
182838606
TX
Enumeration date
04/04/2007
Last updated
04/26/2024
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