Individual
WELTON POLVADO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CPHT
Contact information
Practice address
5808 BURNET RD, AUSTIN, TX 78756-1100
(512) 454-6691
Mailing address
8701 W PARMER LN APT 3125, AUSTIN, TX 78729-4946
Taxonomy
Speciality
Code
Description
License number
State
183700000X
Pharmacy Technician
Primary
264205
TX
Other
Enumeration date
09/29/2021
Last updated
09/29/2021
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