Provider Demographics
NPI:1447252499
Name:POLLAK, DEBORAH LYNN (NP-C)
Entity type:Individual
Prefix:MS
First Name:DEBORAH
Middle Name:LYNN
Last Name:POLLAK
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3590 HUNTERS GLEN RD
Mailing Address - Street 2:
Mailing Address - City:ABILENE
Mailing Address - State:TX
Mailing Address - Zip Code:79605-4922
Mailing Address - Country:US
Mailing Address - Phone:325-695-7433
Mailing Address - Fax:325-673-9989
Practice Address - Street 1:3116 N 1ST ST
Practice Address - Street 2:
Practice Address - City:ABILENE
Practice Address - State:TX
Practice Address - Zip Code:79603-7004
Practice Address - Country:US
Practice Address - Phone:325-673-9987
Practice Address - Fax:325-673-9989
Is Sole Proprietor?:No
Enumeration Date:2005-06-02
Last Update Date:2015-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX670289363LP2300X
IN28172466A363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX157339601Medicaid
TXP44417Medicare UPIN
TX8A5808Medicare ID - Type Unspecified