Individual
KENDALL POLK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CSFA
Contact information
Practice address
205 CRENSHAW DR, MANSFIELD, TX 76063-3451
(214) 927-6539
(817) 394-1231
Mailing address
3540 E. BRAOD ST. STE 102#237, MANSFIELD, TX 76063-9157
(214) 927-6539
(817) 394-1231
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
SA00635
TX
246ZC0007X
Surgical Assistant
Primary
SA00635
TX
246ZS0410X
Surgical Technologist
SA00635
TX
246ZX2200X
Orthopedic Assistant
SA00635
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1225495708
NPI
—
Enumeration date
12/08/2015
Last updated
06/16/2018
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us