Individual
LI JUAN POLVADORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
305 N HEATHERWILDE BLVD, PFLUGERVILLE, TX 78660-3757
(877) 637-8387
Mailing address
4110 BLUE FOREST DR, HUMBLE, TX 77346-3245
(405) 831-0128
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
AP133716
TX
363LF0000X
Family Nurse Practitioner
AP133716
TX
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
AP133716
TX
Other
Enumeration date
03/25/2019
Last updated
08/16/2025
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