Individual
DAN G POLK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
6750 WEST LOOP S, STE 1000, BELLAIRE, TX 77401-4105
(713) 628-4700
Mailing address
6750 WEST LOOP S, STE 1000, BELLAIRE, TX 77401-4105
(713) 628-4700
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
2-5565
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0091DZ
BLUE CROSS BLUE SHIELD
TX
05
—
122378602
—
TX
Enumeration date
06/14/2005
Last updated
10/12/2011
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