Individual
DR. DANIEL POLANCO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
7430 REMCON CIR, BLDG A, EL PASO, TX 79912-3514
(915) 584-0051
(915) 833-1114
Mailing address
7430 REMCON CIR, BLDG A, EL PASO, TX 79912-3514
(915) 584-0051
(915) 833-1114
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
L2557
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1459836-02
—
TX
05
—
145983603
—
TX
01
—
8707B9
MEDICARE
TX
01
—
TXB154608
WELLMED PTAN
TX
Enumeration date
07/01/2005
Last updated
10/15/2015
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