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Individual

DR. JERRY WAYNE POLASEK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1 BAYLOR PLZ, HOUSTON, TX 77030-3411
(281) 217-5119
Mailing address
1602 GANNOWAY LAKE CT, SUGAR LAND, TX 77498-2873
(281) 217-5119

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
M5885
TX
208D00000X
General Practice Physician
M5885
TX

Other

Enumeration date
05/10/2008
Last updated
11/29/2011
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